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乳腺X线摄影、局部数字化处理与立体核心活检对乳腺癌诊断的意义(附122例分析)
Diagnosis of Breast Cancer by HI-TECH Mammography, Digital Spot Image and Stereotactic Core Needle Biopsy: Experience of 122 Patients.
【摘要】 目的:评估立体核心活检在乳腺癌诊断中的意义。方法:1999年3月15日~2000年3月15日,我院外科门诊应用意大利Giotto乳腺诊断系统行高清晰乳腺X线摄影(HI-TECH mammography,HT-M)1888例,对其中符合:①临床扪及乳腺肿块,性质不明;②X线片发现肿块;③X线片上有多形性、集簇性微小钙化灶;④双侧摄片出现局限不对称、高密度区或结构畸形等适应证者,进行数字化局部处理(digital spot image,DSI)与Bard 16G针立体核心活检(stereotactic core needle biopsy,SCNB)122例,占HT-M总数的6.46%。结果:诊断为乳腺癌(包括2例原位导管癌,1例早期导管浸润癌)59例,全部手术证实;良性病变(包括乳腺增生、纤维腺瘤、导管乳头状瘤、囊腺瘤等)63例,其中23例为手术证实,40例随诊中未发现癌变。在乳腺癌中,SCNB真阳性率为89.83%(53/59),假阴性率为10.17%(6/59);乳腺良性病变中SCNB无一例假阳性,故SCNB对乳腺良恶性病变的敏感性和特异性分别为89.83%和100%,全部122例SCNB者均无并发症发生。结论:
【Abstract】 Objective: To explore the value of stereotactic core needle biopsy in diagnosing breast cancer.Me- thods: From March 15, 1999 to March 15, 2000, 1 888 patients were examined by Giltto’s HI-TECH Mam- mography(HT-M) in outpatient clinic. Among them, 122 underwent digital spot image(DSI) and sterotac- tic core needle biopsy(Bard’s needle 16G, SCNB). The indications of DSI and SCNB included: ①Palpable mass; ②A mass found on X-film; ③Pleomorphic cluster microcalcifications on X-film; ④Asymmetry as- sociated with architectural distortion or locally high density on X-film. Results: Fifty-nine cases of breast cancer were proved by pathologic examination(three were intraduct carcinomas in situ or early invasion). The true positive rate of SCNB was 89.83%(53/59) and false negative rate was 10.17%(6/59); Sixty-three ca- ses of benign lesions were proved by operations and follow-up. The sensitivity and specificity of SCNB for malignant tumor were 89.83% and 100% respectively. There was no complication in this group.Conclu- sions: A series of modern equipment including HT-M, DSI and SCNB is essential to gain the precise diag- nosis. Professional team consisted of general surgeons, surgical nurses(technicians) and pathologists should work together and manage the whole course to achieve optimal results.
【Key words】 Breast cancer Mammography Digital spot image Stereotactic core needle biopsy;
- 【文献出处】 外科理论与实践 ,Journal of Surgery Concepts & Practice , 编辑部邮箱 ,2001年04期
- 【分类号】R737.9
- 【被引频次】2
- 【下载频次】38