乳腺穿刺细胞学诊断报告方式的探讨——1999年761例次乳腺穿刺细胞学诊断分析

Review of cytological reporting in breast fine needle aspiration.

目的评价细胞学报告方式对临床的指导价值。方法本文对我院1999年乳腺肿块穿刺细胞学761例次的报告方式进行分析。结果发现我们使用的5组分类法,采取文字描述的报告方式,能恰当反映穿刺的质量、细胞学涂片所见、细胞学诊断与对临床的建议。260例有细胞-组织病理学对照的病例中,乳腺癌细胞诊断的敏感性为79.5%。①类报告(涂片见癌细胞)病例的术中冰冻切片率仅为10.5%,大大低于其它报告类型的病例组,恶性预测值为100%,无假阳性报告。良性病例组细胞学诊断的特异性为100%,良性预测值94.7%。结论乳腺FNA用于可扪及肿块的诊断,应严格掌握阳性诊断标准,尽量避免假阳性的发生。认为确有必要将一些难以确定性质的增生性病变归为一类,与可疑癌的报告同属提示临床有必要作进一步检查的类型。诊断报告也有必要对穿刺涂片质量进行评价,对取材不满意的涂片应予说明。

Objective To evaluate the value of cytological reporting of breast le-sions in clinic practice.Method To analyze761cases of cytological reporting of FNA on breast masses from our hospital in1999.Result5groups reporting of breast FNA properly represented the quality of FNA,the cytological feature of the smears,the cyto-logical diagnosis and recommendation to the clinic.In260cases of cyto-pathologic com-pared,the sensitivity was79.5%in the diagnosis of breast cancer,the frozen section rate was10.5%in the cases of group①reporting(positive for malignant).The malignant predictive value was100%with no false positive report in groups①?②.The specificity was100%and benign predictive value was94.7%in the group of benign disease of the breast.Con clusion since the FNA was mainly used in the diagnosis of palpable breast masses in our clinic practice,a strict criteria diagnosis of malignant should be in-sisted to prevent the false positive.It's necessary to have a group reporting of atypical hyperplasia with undetermine significance to represent the cases of making diagnosis in a dilimina.Together with the groups of″suspicious to malignant″,this group belongs to the reporting which suggest to have further examination needed.It's important to evaluat-ed the quality of FNA and represent it in the reporting especially when it's unsatisfacto-ry