乳腺细针穿刺细胞学检查在乳腺癌定性诊断中的临床应用价值

The clinical value of breast fine needle aspiration cytology (BFNAC) in the diagnosis of breast cancer

目的探讨乳腺癌定性诊断中细针穿刺细胞学(Fine needle aspiration cytology,FNAC)检查的临床应用价值。方法选择2011年1月至2012年12月期间我院诊治的可疑乳腺癌患者72例,将乳腺细针穿刺细胞学检查同超声检查和组织病理学诊断结果进行对比研究,评价乳腺癌定性诊断中细针穿刺细胞学检查的应用价值。结果行乳腺细针吸取细胞学检查72例可疑乳腺癌患者中,FNAC诊断为乳腺癌54例,直接行根治性手术,术后组织病理学诊断均为乳腺癌,假阳性率为0.00%(0/72),假阴性率为4.17%(3/72),特异性和敏感性分别为100.00%(15/15)和94.74%(54/57),总准确率95.83(69/72);与超声检查比较,FNAC检查在假阳性率和特异性方面无统计学意义(P>0.05),但假阴性率明显低于超声检查(χ2=4.143,P<0.05),FNAC检查的敏感性和总准确率明显高于超声检查(P<0.05)。结论 FNAC检查具有安全快速、经济方便、敏感性和准确率高等特点,可为乳腺癌患者术前诊断和手术治疗方式的选择提供依据,临床应用前景广阔。

Objective To explore the clinical value of BFNAC in the diagnosis of breast cancer .Method 72 patients suspicious of breast cancer admitted to the hospital during the period from January ,2011 to December ,2012 were chosen as subjects of the study .Mammary gland fine needle puncture cytological examination with ultrasound was used and compared with histopathologic diagnosis research .The surgical treatment for breast cancer in the fine needle puncture cytological examination of application value was evaluated .Findings For the 72 patients suspected of breast cancer , mammary gland fine needle line absorbing cytology was used , 54 cases were diagnosed as cases of breast cancer by FNAC and radical surgery directly, postoperative histopathological diagnosis of breast cancer .The false positive rate was 0.00%（0/72）, and the false negative rate was 4.17% （3/72）.Specificity and sensitivity was 100.00% （15/15） and 94.74% （54/57） respectively, the total accuracy was 95.83%（69/72）; there showed no statistical significance between ultrasound andFNAC check in terms of false positive rate and specificity （P 〉0.05）, but the FNAC check the false negative rate wassignificantly lower than the ultrasound, showing statistical significance （χ2 =4.143, P 〈0.05）.The sensitivity and thetotal accuracy of FNAC inspection was obviously higher than that of ultrasound .The difference has statistical significance（P 〈0.05）.Conclusion FNAC check is found to be safe and fast, economical, convenient , of high sensitivity andaccuracy.It can be effective in preoperative diagnosis of breast cancer .