乳腺腫物細針吸取活檢——664例病例分析及誤導診斷因素的探討

Fine-Needle Aspiration Biopsies of Breast Masses-664 cases analysis and discussion about the diagnostic pitfall

總結本院1989.9-1994.6乳腺種物細針吸取活檢(FNAB)664例,經手術治療后獲組織病理學證實者204例,其中40例為惡性腫瘤,其診斷敏感性為95%,特異性為97%。細胞學診斷為陽性者(Ⅳ,Ⅴ級)手術后證實全部為惡性。文中對誤導診斷的因素:不典型的細胞學改變,出現異型細胞的良性病變及易于漏診的乳腺癌等進行了簡單的討論。

A series of 664 fine-needle aspiration biopsies(FNAB)of breast masses done at my department during the period September 1989 to June 1994 was analyzed.There were 204 cases,who subsequently accepted operation(excisional biopsy or mastectomy)and having histologic diagnoses.Cytologic diagnoses were classified into four diagnostic classes and six grades:positive(Grade Ⅳ,Grade Ⅴ)for malignant cells,negative for malignant cells(Grade Ⅰ,Grade Ⅱ),cytologically suspect(Grade Ⅲ)and unsatisfactory(Grade 0,not enough epithelial cell for diagnosis).Table 1 shows the diagnostic distribution of the 664 breast FNAB.Sensitivity of FNAB for breast malignant tumor was 95% and specificity was 97%.All positive cases in FNAB(Grade Ⅳ,Ⅴ)Were proved to be malignant tumor by operation.To recognize the cytologic diag・nostic pitfalls is very important for a correct diagnosis.The common diagnostic pitfalls include atypical cytologic changes,atypical cells appearing in benign lesion and some easily neglected cases of breast carcinoma.