纤维乳管内视镜在乳头溢液中的临床应用

Clinical application of fiberoptic ductoscopy in patients with abnormal nipple secretion

目的:评估纤维乳管内视镜在乳头溢液诊治中的临床价值。方法:使用日本制造的FT-201超细纤维乳管内视镜,对264例乳头溢液患者进行检查和治疗。结果:本研究对264例,共270个溢液孔成功插入264个孔(98%),发现早期乳管内癌12例(4.5%),乳头状瘤83例(31.4%),乳头状瘤病4例(1.5%),导管扩张伴炎症127例(48%),正常导管38例(14.5%)。活检吸出肿块10例,导管慢性炎症进行冲洗药物灌注痊愈45例,手术共107例。经病理证实符合率达95%。溢液涂片阳性率是乳管内视镜阳性率的1/3。结论:乳管内视镜可插入到Ⅴ级导管,能发现早期乳腺癌、乳管内乳头状瘤,对导管慢性炎症可用药物治疗,对导管内病变定位、定性准确,减少盲目手术,对乳腺外科在诊断、治疗和早期发现上具有深远价值。

Objective： This study evaluated the clinical effect of FDS in diagnosis and treatment of abnormal nipple secretion. Methocls： 264 cases with abnormal nipple secretion were examined and treated by FT- 201 type superfine fiberoptic ductoscopy system made in Japan. Results： FDS was inserted success fully into 264 cases from 270 cases in this group （98%）. Among 264 cases early breast cancer was 12 cases （4.5%）, papilloma and papillomatosis was 87 cases （32.9%）, and ductal ectasia and or chronic inflammation was 127 cases （48%） ; duct endoscopic was successfully performed in 10 cases, 45 cases were cured of chronic inflammation by drug perfusion, 107 cases were operated in which coincidence rate was 95% after pathological diagnosis, and in which the positive rate of smear cytology was only 1/ 3 of that of FDS. Conclusion： FDS can availably insert into 5th ductal lumen and detect early breast cancer, which will bring great influence upon the galactophore surgery and reduce blind operation due to the accurating location and prognesing qualitation.