导管镜对导管内乳头状瘤诊断的局限性

Limitation of diagnosis on intraductal papilloma by fiberoptic ductoscopy

目的评价导管镜对导管内乳头状瘤诊断的正确性,并分析导管镜对导管内乳头状瘤诊断的局限性所在。方法 2008年4月～2010年4月中南大学湘雅医院乳腺科乳腺导管镜检查诊断为导管内乳头状瘤的113名患者,均采取手术治疗,将乳管镜结果、手术情况、体察结果、B超结果和病理结果进行总结分析。结果 89例患者中术后病理证实为导管瘤(78.8%),乳腺腺病5例(4.4%),纤维囊性乳腺病9例(8.0%),导管扩张和(或)合并炎症9例(8.0%),导管内癌1例(0.8%)。结论乳管镜诊断为导管内乳头状瘤的患者经手术证实仅有78.8%的正确率,虽然通过结合术前乳腺导管定位针,以及体查和B超结果,能够大幅度提高其准确性,但仍存在一定的局限性。

【Objective】To evaluate the accuracy in the diagnosis of the intraductal papilloma by fiberoptic ductoscopy （FDS）, and analyze the limitation of FDS diagnosis on intraductal papilloma. 【Methods】113 patients in breast department of Xiangya Hospital from April 2008 to April 2010 who were diagnosed to intraductal papilloma by FDS were taken to surgery, the results of FDS,surgical findings,physical examination,B ultrasound and pathological reports were analyzed. 【Results】89 patients were pathologically confirmed intraductal papilloma （78.8%）, breast adenosis in 5 cases （4.4%）, fibrocystic breast disease in 9 cases（8.0%）, ductal dilatation and/or inflammation 9 cases （8.0%）, ductal carcinoma in 1 case （0.8%）.【Conclusions】Through the surgical confirmation, the accuracy in the diagnosis of the intraductal papilloma by FDS was only 78.8%, but with the combination of preoperative needle localization of FDS, the physical examination and B ultrasound report it can significantly be improved, but somewhat the limitation still exist.