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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.

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【作者】 吴功侃起荣宇吴蓉由翠珍

【Author】 Wu Gongkan, Zhao Rongyu, Wu Rong, et al. Department of Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning(116011)

【机构】 大连医科大学附属第一医院普外科!(116011)

【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.

  • 【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
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