纤维乳管镜联合癌胚抗原在诊治乳头溢液疾病中应用

Application of Fiberoptic Ductograph Combined with Carcinoembryonic Antigen in Diagnosis and Treatment of Nipple Discharge Diseases

目的研究纤维乳管镜联合癌胚抗原在诊治乳头溢液疾病中应用。方法方便选取2016年10月—2017年12月在该院治疗的乳头溢液患者80例,选取同期来该院进行健康体检的产妇40名为对照组,对比两组人员的疾病分布、溢液性质、癌胚抗原水平以及检测结果。结果纤维乳管镜下双侧溢液与单侧溢液患者的乳管癌、乳管扩张及炎症以及乳头状瘤等疾病所占比例差异无统计学意义(χ^2=1.794、1.391、2.125,P=0.061、0.068、0.057);乳管癌主要为血性溢液,乳管扩张及炎症主要为乳汁样溢液,乳头状瘤主要为浆液性溢液,乳头状瘤病主要为浆液性溢液,差异有统计学意义(χ^2=5.064、5.944、4.538、6.068,P=0.043、0.041、0.045、0.047);研究组患者的血清及乳头溢液中癌胚抗原水平(9.83±3.35)μg/L、(23.19±11.04)ng/mL均明显于高于对照组(9.57±2.93)μg/L,(12.68±3.48)ng/mL,差异有统计学意义(t=14.345、15.475,P=0.047、0.042);对照组人员乳头溢液中癌胚抗原主要为阴性,研究组患者乳头溢液中癌胚抗原主要为阳性和强阳性,差异有统计学意义(χ^2=6.124、5.532、6.534、5.946,P=0.036、0.044、0.032、0.041)。结论在乳头溢液的诊治过程中,通过纤维乳管镜可以直观、准确的了解乳头溢液的病变范围、病因以及病变部位,癌胚抗原检测是乳头溢液早期诊断的一种辅助方法,纤维乳管镜联合癌胚抗原能够提高乳头溢液的检出率,因此临床上应当进一步的推广与应用。

Objective To study the application of fiberoptic ductograph combined with carcinoembryonic antigen in diagnosis and treatment of nipple discharge diseases.Methods A total of 80 cases of nipple discharge admitted to our hospital from October 2016 to December 2017 were convenient selected,and 40 cases of maternal health examination in our hospital were selected as the control group.The distribution of disease,the nature of the spillage,the level of carcinoembryonic antigen and the results of the detection were compared between the two groups.Results There was no significant difference in the proportion of breast cancer,ductal dilatation,inflammation and papilloma between patients with bilateral and unilateral discharge under fiberoptic ductoscopy(χ^2=1.794,1.391,2.125,P=0.061,0.068,0.057).Breast cancer was mainly hemorrhagic discharge;ductal dilatation and inflammation were mainly papillary discharge;papilloma was mainly serous discharge;papilloma was mainly serous discharge.The difference was statistically significant(χ^2=5.064,5.944,4.538,6.068,P=0.043,0.041,0.045,0.047).The carcinoembryonic antigen levels of serum and papillary discharge in the experimental group(9.83±3.35)μg/L,(23.19±11.04)ng/mL were significantly higher than those in the control group(9.57±2.93)μg/L,(12.68±3.48)ng/mL,with significant difference(t=14.345,15.475,P=0.047,0.042).The carcinoembryonic antigen in the nipple discharge of the control group was mainly negative,while the carcinoembryonic antigen in the nipple discharge of the experimental group was mainly positive and strongly positive.The difference was statistically significant(χ^2=6.124,5.532,6.534,5.946,P=0.036,0.044,0.032,0.041).Conclusion In the process of diagnosis and treatment of nipple discharge,the scope,etiology and location of the nipple discharge can be understood intuitively and accurately by fiberoptic ductoscopy.And the detection of carcinoembryonic antigen is an auxiliary method for the early diagnosis of nipple discharge.The combined use of fiberoptic ductoscope and carcinoembryonic antigen can improve the detection rate of nipple discharge.It should be further popularized and applied in clinic.