乳管内窥镜在乳头溢液中的临床应用200例

Clinical application of breast fiberoptic ductoscopy in 200 cases with abnormal nipple discharge

目的 评价乳管内窥镜对乳头溢液诊治的作用。方法 应用FVS 35 0 0乳腺纤维导管镜系统对 2 0 0例乳头溢液患者进行诊治。结果 本组 2 0 0例 ,共 2 10个溢液孔 ,插入 2 0 4个孔 ,成功率达 97 0 %。本组发现早期乳腺癌 9例 (4 5 % ) ,乳头状瘤 6 3例 (31 5 % ) ,乳头状瘤病 3例 (1 5 % ) ,导管扩张或伴炎症 96例 (4 8 0 % ) ,“正常”导管 2 9例 (14 5 % )。活检吸出肿块 10例 ,导管慢性炎症灌注药物冲洗治愈 2 5例 ,手术患者共 6 7例 ,经病理证实符合率达 95 0 % ,乳头溢液涂片检查阳性率仅为乳管内窥镜的 1/ 3。结论 乳管内窥镜可插入到 4级乳腺导管 ,能早期诊断乳腺癌。对部分乳头状瘤和导管慢性炎症可以作介入治疗 。

Objective This study was to evaluate breast fiberoptic ductoscopy (FDS) in the diagnosis and treatment of abnormal niple discharge(AND). [WT5”HZ]Methods [WT5”BZ] FVS 3500 superfine fiberscopy system was used to treat and diagnose 200 cases with AND. [WT5”HZ]Results [WT5”BZ] 210 orifices of nipple discharge were found in this group. FDS was successfully inserted into 204 orifices(97 0%).Early breast cancer was found in 9 cases(4 5%), papilloma and papillomatosis in 66 cases(33 0%),ductal ectasia and/or chronic inflammation in 96 cases(48 0%); “normal duct” in 29 cases(14 5%). Duct endoscopic biopsy was carried out in 10 cases. Chronic inflammation was cured by perfusion in 25 cases. 67 cases underwent surgery, diagnosis was confirmed by pathology in 95 0% with a positive rate 3 times as high as that of smear cytology.Conclusions FDS enables the evaluation on 4th ductal lumen and detection of early breast cancer. Interventional treatment was successful in some intraductal papilloma and chronic inflammatory disease.