乳腺癌细针穿刺活检的临床应用价值

The clinical value of fi ne needle biopsy in breast cancer

背景与目的:随着乳腺癌术前诊疗手段的发展,细针穿刺似乎不再受临床医生的青睐。细针穿刺作为乳腺癌的术前诊断方法之一,其安全及有效性存在争议。本研究探讨30年来我院乳腺癌细针穿刺与复发、转移的关系。方法:统计我院1975—2006年1 260例乳腺癌患者的临床资料,根据是否术前细针穿刺分组,比较2组间临床基本特点、复发转移率、无瘤生存率。结果:细针穿刺阳性率为61.4%,其中Ⅳ期患者阳性率最高,达100%;细针穿刺组中以Ⅱ期和Ⅲ期患者居多,均为45.2%;细针穿刺组和非细针穿刺组的局部复发率(7.0%vs 6.4%)、复发转移率(13.2%vs 14.0%)、5年无瘤生存率(82.0%vs 81.0%)及10年无瘤生存率(51.0%vs 64.0%)差异均无统计学意义。结论:细针穿刺具有易操作、阳性率高、对复发及生存无影响等优点,因此对乳腺癌患者的术前诊断仍有较高的临床应用价值。

Background and purpose： With the development of the means of preoperative diagnosis and treatment of breast cancer, fine needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration （FNA） of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods： A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results： The positive rate of FNA was 61.4% and the highest rate was in Ⅳ stage （100%）. Stage Ⅱ and Ⅲ were the major ones in FNA group （45.2%）. The local recurrence （7.0% vs 6.4%）, recurrence and metastasis （13.2% vs 14.0%）, 5-year （82.0% vs 81.0%） and 10- year disease free survival rates （51.0% vs 64.0%） have no significant difference between FNA and non-FNA groups. Conclusion： FNA is still one of the most important methods for preoperative investigation of breast cancer.