乳腺肿块针吸细胞学361例诊断分析

Diagnosis of breast masses by fine needle aspiration cytology:analyses of 361 cases

目的探讨乳腺肿块针吸细胞学(FNAC)诊断的标准,分析误诊原因及改进方法。方法分析我院361例经组织病理学对照的乳腺肿块FNAC检查结果,比较良、恶性肿瘤在临床触诊检查、针感体验及细胞形态学方面的差异。结果经组织病理学对照后,FNAC诊断恶性病变186例,良性病变175例,26例误诊,总准确率为92.8%,总误诊率为7.2%。良、恶性肿瘤在细胞学形态、触诊检查及针感体验方面差异显著(P<0.05)。结论FNAC诊断乳腺恶性病变的准确率达到临床诊断要求,以显微镜镜下细胞形态学为主,再结合触诊、针感及其他组织学检查方法可有效提高诊断准确率。

Objective To investigate the diagnostic standard of fine needle aspiration cytology （FNAC） for breast masses,to study the reasons of false diagnosis and to improve its methodology.Methods The results of 361 cases of breast masses by FNAC were analyzed in our hospital,and their cytological and histopathological diagnoses were compared.The difference of the malignant tumor and the benign lesion of breast masses in the clinical palpation,sense of puncture and morphological characteristics were compared.Results By histopathological comparison,86 cases of FNAC were diagnozed as malignant,and 175 cases as benign; there ware 28 mis-diagnosed cases.The total accuracy rate and the total mis-diagnosis rate of FNAC for breast masses were 92.8％ and 7.2％,respectively.The difference between the malignant tumor and the benign lesion in the clinical palpation,sense of puncture and morphological characteristics was significant （P ＜ 0.05）.Conclusion The accuracy rate of FNAC diagnosis for breast masses has special value for pathologists to diagnose the malignant tumor.To relay the morphological characteristics mainly,combined with the clinical palpation and sense of puncture will facilitate the differential diagnosis.