摘要
目的评价超声引导空芯针穿刺活检(US-CNB)在乳腺病变术前诊断中的应用价值。方法宁夏医科大学附属医院肿瘤外科2007年8月至2009年5月行超声引导空芯针穿刺活检病人115例,结合手术后病理切片,对空芯针穿刺活检标本和切除活检(EP)标本的病理组织学诊断进行比较和分析。结果 115例乳腺疾病病人经空芯针穿刺活检组织学诊断浸润性导管癌81例,浸润性小叶癌3例,导管内癌2例,交界性肿瘤1例,导管上皮不典型增生2例,其他良性病变26例。US-CNB与切除活检的病理诊断符合率为93.9%,kappa=0.891(P<0.01)。US-CNB病理诊断的敏感性为95.6%,特异性为100%,假阴性4.39%,无假阳性。结论超声引导下空芯针穿刺活检是一种敏感性高、特异性强的乳腺病变诊断方法,对少数特殊类型乳腺病变的诊断存在一定的局限性,对于任何可疑病变或不典型增生改变均应做切除活检。
Objective To evaluate the clinical value of ultrasound-guided core needle biopsy（US-CNB） as a preoperative diagnostic modality for breast lesions.Methods Data were collected prospectively from August 2007 to May 2009 for 115 ultrasound-guided core needle biopsy that were followed by excisional breast procedure（EP） within 1 week at our hospital.The histopathological diagnosis on ultrasound-guided core needle biopsy was then compared with the findings of the excisional biopsy.Results Out of the total 115 cases,US-CNB showed 81 as invasive ductal carcinoma,three invasive lobular carcinoma,two ductal carcinoma in situ,two atypical ductal hyperplasia and 26 benign disease.The principle histology identified at CNB was confirmed at EP for 93.9% of the lesions,generating a kappa value of 0.891（P0.01）.The sensitivity for malignancy with CNB was 95.6% and the specificity was 100%.The false negative rate was 4.39% and the false positive rate was 0.Overall,our results indicate moderate agreement between the principal histology identified at USB relative to that identified at EP.Conclusions Ultrasound-guided core breast biopsy is a satisfactory procedure for the histopathological diagnosis of breast lesions.Any unsatisfactory,suspicious or atypical change on US-CNB should be followed by an open biopsy.
出处
《中国实用外科杂志》
CSCD
北大核心
2010年第12期1053-1055,共3页
Chinese Journal of Practical Surgery
基金
宁夏医科大学面上项目(No20090012F)
关键词
超声引导空芯针穿刺
切除活检
乳腺癌
组织学诊断
ultrasound-guided core needle biopsy
excisional breast biopsy
ereast cancer
histological diagnosis
