乳腺病变冰冻切片误诊及延迟诊断分析

Misdiognosis and delayed diagnosis of breast lesions by frozen section

目的:分析乳腺病变冰冻误诊及延迟诊断原因,提高冰冻诊断准确性。方法:收集2007年1月～2010年1月间乳腺术中冰冻切片,把乳腺病变分为良性病变、交界性病变和恶性病变,将冰冻切片与石蜡切片对比分析。结果:乳腺冰冻诊断假阴性(误诊)2例分别为神经内分泌癌和乳头状癌,其主要原因对疾病认识不足和取材不到位;延迟诊断6例分别是硬化性腺病3例、浸润性导管癌1例、非典型乳头状瘤1例、交界性叶状肿瘤1例,主要原因是这些乳腺病变在冰冻诊断中的存在陷阱、取材不当、制片不良等因素导致延迟诊断。结论:乳腺病变复杂在冰冻诊断辨认困难,有必要加强对乳腺病变的认识,避免给患者造成不要挽回的损失。

Objective To analyze the misdiagnosis of breast lesions by frozen and the reasons for delayed diagnosis,in order to improve the diagnostic accuracy of frozen.Method Collected intraoperative frozen section of breast.The breast lesions were divided into the benign,borderline lesion and malignant lesion.The frozen sections were compared with paraffin sections.Results False negative diagnosis of breast frozen（misdiagnosis） in 2 cases were neuroendocrine carcinoma and papillary carcinoma.The main reason for lack of knowledge on the disease and drawn not in place;6 cases of delayed diagnosis were 3 cases of sclerosing adenosis,1 case of invasive ductal carcinoma,1 case of atypical papilloma and borderline phyllodes tumor in 1.The main reasons of delayed diagnosis were breast lesions in a number of pitfalls of frozen,drawn incorrectly,production factors such as delay in diagnosis of non-performing.Conclusion Diagnosis of breast lesions to identify complex problems in the frozen.The need to strengthen the understanding of breast lesions,do not restore patients to avoid causing the loss.