纤维乳腺导管内镜辅助诊治乳头溢液632例报告

Breast Duct Endoscopy for the Diagnosis and Treatment of Nipple Discharge: Report of 632 Cases

目的探讨纤维乳腺导管内镜对Tis期乳腺癌的临床诊断价值。方法 2001年5月～2010年5月,对632例乳头溢液进行乳腺导管内镜检查702次,并对其中310例隆起性病变行乳腺导管内镜辅助定位手术。结果 475例诊断为隆起性病变,包括乳管内乳头状瘤388例(61.4%),乳管内乳头状瘤病79例(12.5%),导管内癌8例(1.3%);157例为非隆起性病变,包括导管扩张症82例(13.0%),慢性乳管炎73例(11.6%)和导管内癌2例(0.3%)。310例行乳腺导管内镜辅助定位手术,内镜诊断对导管内癌的阳性预测值为83.3%(10/12)。结论 纤维乳腺导管内镜检查弥补了伴有乳头溢液的Tis期乳腺癌诊断的空白,对乳腺癌的早期诊断有积极的意义。

Objective To discuss the clinical value of fiber ductoscopy for diagnosing Tis stage breast cancer. MethodsSince May 2001 to May 2010,we conducted fiber ductoscopy on totally 632 cases of nipple discharge（702 examinations）,and performed fiber ductoscopy-assisted surgery on 310 of the patients who had protuberant lesions. Results Among the cases,475 patients were diagnosed with protruded lesions,including 388 cases of intraductal papilloma（61.4%）,79 cases of intraductal papillomatosis（12.5%）,and 8 cases of ductal Tis carcinoma（1.3%）;the other 157 cases showed non-protuberant lesions,including 82 cases of duct ectasia（13.0%）,73 cases of chronic duct inflammation（11.6%）,and 2 cases of ductal Tis carcinoma（0.3%）.In the patients who had protruded lesions,310 underwent breast duct endoscopy-assisted positioning for surgery.The fiber ductoscopy showed a positive predictive value of 83.3%（10/12） for ductal Tis carcinoma in our hospital.Conclusion Breast fiber ductoscopy is a supplement to the diagnosis of Tis breast cancer with nipple discharge,and thus is a valuable method for diagnosing early-stage breast cancer.