超声引导下乳腺肿块穿刺活检的临床研究

Clinical study of ultrasound guided-core needle biopsy in breast masses

目的探讨超声引导穿刺活检(Ultrasound guided-Core Needle Biopsy,US-CNB)在乳腺肿块诊断中的临床价值。方法回顾性分析2018年1月—2020年1月徐州市中心医院收治的乳腺肿块患者437例共454枚肿块BI-RADS-US分类评估并行US-CNB,将结果与术后病理及随访结果进行比较,评价US-CNB对乳腺肿块的诊断效能及一致性情况。结果所有肿块均穿刺成功获取病理结果,2例术后出现血肿。454枚乳腺肿块中,恶性肿块93枚,良性肿块361枚;431例女性患者中91枚肿块为恶性,6例男性患者中2枚肿块为恶性。US-CNB诊断中有1枚3类肿块、3枚4A类肿块及1枚4B类肿块与术后病理及随访结果不符。乳腺肿块US-CNB诊断敏感度94.90%,特异度100%,阳性预测值100%,阴性预测值98.61%,BI-RADS分类各指标间差异无统计学意义(P>0.05)。US-CNB诊断准确度为98.90%,κ=0.967(P<0.05),具有良好的一致性。结论US-CNB诊断乳腺肿块的性质与术后病理及随访结果一致性好,为临床治疗方案的选择及预后的判断提供了可靠的病理依据。

Objective To investigate the clinical value of ultrasound guided-core needle biopsy(US-CNB)in the diagnosis of breast masses.Methods A total of 437 patients with 454 breast masses admitted to the Xuzhou Central Hospital from January 2018 to January 2020 were retrospectively analyzed,which were diagnosed by conventional ultrasound and classified by BI-RADS-US and sub⁃jected to US-CNB,the results were compared with postoperative pathology and follow-up results,and the diagnostic efficacy and con⁃sistency of US-CNB in the diagnosis of breast masses were evaluated.Results All the masses were punctured successfully to obtain pathological results,and hematoma occurred in two cases after operation.Among the 454 breast masses,93 were malignant masses and 361 were benign masses.91 masses of the 431 female patients were malignant and 2 masses of the 6 male patients were malignant.In the diagnosis of US-CNB,there were 1 case in BI-RADS 3,3 cases in BI-RADS 4A,and 1 case in BI-RADS 4B were inconsistent with postoperative pathology and follow-up results.The diagnostic sensitivity,specificity,positive predictive value and negative predic⁃tive value of US-CNB for breast masses were 94.90%,100%,and 98.61%,respectively.There were no significant differences between the indicators of BI-RADS classification(P>0.05).US-CNB was well consistent with the postoperative pathology and follow-up results in terms of diagnostic accuracy of 98.90%,κ=0.967(P<0.05).Conclusion The results of US-CNB in the diagnosis of breast mas⁃ses were consistent with the postoperative pathology and follow-up results,providing a reliable pathological basis for the selection of 6 Modern Instruments&Medical Treatment,2023,Vol.29 No.6 clinical treatment options and prognosis judgment.