术中快速冰冻组织活检应用于乳腺肿块性状诊断中的价值

The value of intraoperative frozen tissue biopsy in the diagnosis of breast mass characteristics

目的 探讨术中快速冰冻组织活检应用于乳腺肿块性状诊断中的价值。方法 118例乳腺肿块患者,均行超声引导下穿刺活检、术中快速冰冻组织活检及术后石蜡病理切片诊断,比较术后石蜡病理切片、术中快速冰冻组织活检及超声引导下穿刺活检诊断结果;以术后石蜡病理切片结果为金标准,对比超声引导下穿刺活检与术中快速冰冻组织活检的诊断效能。结果 术后石蜡病理切片诊断乳腺肿块的非肿瘤病变20例、良性肿瘤病变31例、恶性肿瘤病变67例,术中快速冰冻组织活检诊断分别为21、33、64例,超声引导下穿刺活检诊断分别为19、44、55例。超声引导下穿刺活检、术中快速冰冻组织活检及术后石蜡病理切片的诊断结果比较差异有统计学意义(P<0.05)。以术后石蜡病理切片结果为金标准,术中快速冰冻组织活检诊断特异度为94.12%、敏感度为91.04%、准确度为92.37%;超声引导下穿刺活检诊断特异度为92.16%、敏感度为76.12%、准确度为83.05%。术中快速冰冻组织活检诊断敏感度及准确度均高于超声引导下穿刺活检,差异有统计学意义(P<0.05);术中快速冰冻组织活检与超声引导下穿刺活检诊断特异度比较差异无统计学意义(P>0.05)。结论 相较于超声引导下穿刺活检,术中快速冰冻组织活检鉴别诊断乳腺肿块性质的总体价值较高。

Objective To discuss the value of intraoperative frozen tissue biopsy in the diagnosis of breast mass characteristics.Methods All 118 patients with breast masses underwent ultrasound-guided biopsy,intraoperative frozen tissue biopsy,and postoperative paraffin pathological section diagnosis,and their diagnostic results were compared.The results of postoperative paraffin pathological sections were used as the gold standard to compare the diagnostic results and diagnostic efficiency of ultrasound-guided biopsy and intraoperative frozen tissue biopsy.Results Postoperative paraffin pathological sections diagnosed 20 cases of non-tumor lesions,31 cases of benign tumor lesions and 67 cases of malignant tumor lesions in breast masses;intraoperative frozen tissue biopsy diagnosed 21 cases of non-tumor lesions,33 cases of benign tumor lesions and 64 cases of malignant tumor lesions in breast masses;ultrasound-guided biopsy diagnosed 19 cases of non-tumor lesions,44 cases of benign tumor lesions and 55 cases of malignant tumor lesions in breast masses.The differences in diagnostic results among ultrasound-guided biopsy,intraoperative frozen tissue biopsy and postoperative paraffin pathological sections were statistically significant(P<0.05).With the results of postoperative paraffin pathological sections,the diagnostic specificity,sensitivity and accuracy of intraoperative frozen tissue biopsy were 94.12%,91.04%and 92.37%respectively;the specificity,sensitivity and accuracy of ultrasound-guided biopsy were 92.16%,76.12%and 83.05%respectively.The intraoperative frozen tissue biopsy had higher diagnostic sensitivity and accuracy than ultrasound-guided biopsy,and the difference was statistically significant(P<0.05),while the difference in diagnostic specificity between intraoperative frozen tissue biopsy and ultrasound-guided biopsy was not statistically significant(P>0.05).Conclusion Compared with ultrasound-guided biopsy,intraoperative frozen tissue biopsy has a higher overall value in the differential diagnosis of breast masses.