病理性乳头溢液临床病理分析

Clinicopathological features of pathological nipple discharge

目的 分析病理性乳头溢液(PND)的临床病理特征,探讨PND组与对照组的差异,寻找PND相关的病理组织学高危因素,为PND的诊断、治疗及预后判断提供依据。方法 收集西北妇女儿童医院2010—2020的1880例PND患者的临床病理资料,以无明显乳头溢液的患者为对照组,分析PND组和对照组患者的临床与组织病理学特征,并进行统计学分析。结果 溢液中异型细胞、细胞核级别、血性溢液、导管上皮非典型增生(ADH)、导管原位癌(DCIS)、纤维囊性增生症及雌激素受体(ER)弥漫强阳性表达与PND有相关性(P<0.05)。年龄、导管上皮普通型增生(UDH)、孕激素受体(PR)弥漫强阳性表达、间质血管瘤样增生和影像学BI-RADS分级与PND无显著相关性。结论 无论年龄和影像学检查结果如何,对PND患者都有必要进行乳管镜检查及病理活检。

Objective To analyze the clinicopathological characteristics of pathological nipple discharge(PND), to explore the difference between PND group and control group, to find PND related pathological high risk factors and common pathological changes and to provide scientific basis for the diagnosis, treatment and prognosis of PND. Methods A total of 1880 PND patients from 2010 to 2020 were collected and statistically analyzed. Results There was a significant correlation between the presence of abnormal cells, blood overflow, atypical ductal hyperplasia(ADH), ductal carcinoma in situ(DCIS), nuclear grade, fibrous cystic hyperplasia and diffuse and strongly positive expression of estrogen receptor(ER) and PND(P<0.05). There was no significant correlation between age, usual ductal hyperplasia(UDH), progesterone receptor(PR) diffuse strong positive expression, interstitial hemangioma-like hyperplasia and imaging BI-RADS grade and PND. Conclusion Pathological biopsy is necessary for PND patients regardless of age and imaging result.