浅谈乳腺肿块针吸细胞学诊断体会

 目的　探讨乳腺肿块FNAC的诊断及影响其准确率的因素。方法　回顾 1115例乳腺肿块FNAC的诊断 ,分析其特点及诊断要点。结果　 1115例乳腺肿块FNAC中 ,有 32 8例获病理组织学对照 ,FNAC总正确率 96 .3% ,总误诊率 3.7% ;假阴性率 4 .8% ,潜在假阳性率 1.7% ,无 1例假阳性。可疑癌占 5 .6 5 % (6 3/ 1115 )。结论　FNAC对乳腺癌的早期发现及明确诊断有重要意义 ,对临床术前判断良恶性具有独特价值。     

针吸及印片细胞学在乳腺肿块诊断中的意义

目的　提高乳腺肿块细胞病理学检查的准确性。方法　对 3 3 1例乳腺肿块细针吸取细胞学检查 (FNAC)、术中印片与其术后病理组织学诊断对照分析。结果　 13 6例乳腺恶性肿瘤 ,FNAC确诊率 86% ( 117/ 13 6) ,假阴性率 3 7% ( 5 / 13 6) ,无假阳性诊断。 195例良性病变 ,FNAC确诊率 94 9% ( 185 / 195 )。诊断符合率 95 5 %。术中印片纠正 5例假阴性诊断 ,2 2例可疑病变得到确诊 ,印片对恶性肿瘤的确诊率为 98 5 % ,诊断符合率达 10 0 %。结论　FNAC、印片是乳腺肿块之便捷、有效的辅助诊断方法 ,能部份替代乳腺癌术前或术中活组织检查。重视体检 ,掌握临床资料 ,采取FNAC与术中印片相结合 ,可减少误漏诊。     

可触及包块的乳腺癌术前针吸细胞学检查的临床意义

目的探讨可触及包块乳腺癌在术前进行针吸细胞学检查(fine needle aspiration cytolo-gy,FNAC)的方法和临床意义。方法回顾总结2009年9月至2011年9月有病理组织学诊断的乳腺癌140例,与术前FNAC结果比较。结果 140例乳腺癌细胞学检查阳性检出率为91.4%(128/140),假阴性率8.6%(12/140),其中原位癌检出率81.3%(13/16),单纯癌及浸润性导管癌检出率93.2%(96/103),髓样癌检出率94.1%(16/17),硬癌检出率50.0%(1/2),黏液癌检出率0(0/2)。结论 FNAC在可触及肿块乳腺癌的诊断中具有方法简便、安全微创、诊断快速准确率高的特点。     

323例乳腺肿块针吸细胞学诊断分析(英文)

目的探讨乳腺癌针吸细胞学(FNAC)诊断准确性。方法分析1326例乳腺肿块针吸细胞学诊断,并与323例手术后病理组织学诊断结果对比。结果本组 FNAC 诊断敏感性为97.1%,特异性为97.3%,假阳性率为2.7%,假阴性率为2.9%,诊断符合为97.2%。结论乳腺肿块 FNAC 检查是一种实用价值很高的诊断方法。文中对影响 FNAC 诊断的因素进行了讨论。     

针吸及印片细胞学在乳腺肿块诊断中的意义

目的 提高乳腺肿块细胞病理学检查的准确性。方法 对33l例乳腺肿块细针吸取细胞学检查(FNAC)、术中印片与其术后病理组织学诊断对照分析。结果 136例乳腺恶性肿瘤，FNAC确诊率86％(117／136)，假阴性率3．7％(5／136)，无假阳性诊断。195例良性病变，FNAC确诊率94．9％(185／195)。诊断符合率95．5％。术中印片纠正5例假阴性诊断，22例可疑病变得到确诊，印片对恶性肿瘤的确诊率为98．50%，诊断符合率达100％。结论 FNAC、印片是乳腺肿块之便捷、有效的辅助诊断方法，能部份替代乳腺癌术前或术中活组织检查。重视体检，掌握临床资料，采取FNAC与术中印片相结合，可减少误漏诊。     

细针穿刺细胞学检查在乳腺肿块筛查及乳腺恶性肿瘤分型诊断中的意义

目的探讨细针穿刺细胞学(FNAC)检查对乳腺肿块良恶性筛查及其对乳腺癌分型诊断的准确性。 方法根据纳入、排除标准,选取2015年2月至2017年2月清华大学第一附属医院诊治的279例同时行FNAC和组织病理学检查的乳腺肿块患者进行回顾性研究。将患者的FNAC和病理组织学检查结果进行对照分析。采用一致性检验Kappa值评价FNAC与病理组织学检查在乳腺肿块筛查及分型中的一致性,并用受试者工作特征(ROC)曲线下面积评价FNAC的诊断准确性。 结果在279例患者中,FNAC诊断乳腺病变的准确率为90.3%(252/279)。FNAC诊断乳腺病变的敏感度为85.0%(125/147),特异度为96.2%(127/132),假阳性率为3.8%(5/132),假阴性率为15.0%(22/147),阳性似然比为22.4,阴性似然比为0.2。FNAC与组织病理学检查方法的一致性检验显示,Kappa值为0.81(P<0.001)。FNAC的诊断性能评价指标ROC曲线下面积为0.95(P<0.001)。在本组患者中,有125例患者FNAC与组织病理学均确诊为乳腺恶性肿瘤。而在125例乳腺癌患者中,2种方法进行分型诊断的一致性检验显示,Kappa值为0.68(P<0.001)。 结论FNAC可以作为一种很好的乳腺肿块良恶性筛查方法,在诊断为乳腺癌的患者中也有较好的术前分型价值,可以尝试进行临床分型,为临床的治疗提供依据。     

327例乳腺肿块针吸细胞学与组织学检查对比分析

目的:探讨乳腺针吸细胞学检查(FNAC)对乳腺癌诊断的准确性.方法:对1062例乳腺肿块行FNAC检查,其中327例获得病理组织学对照.结果:本组针吸细胞学检查敏感性为97.3%,特异性为95.0%,潜在假阴性率2.7%,符合率95.4%.结论:(1)针吸细胞学是检查乳腺肿块的一种重要的辅助诊断方法,但仍存在一定的局限性,对疑难病例需要通过病理组织学确诊.(2)肿块实质细胞较少或细胞异形性不明显是阴性诊断的主要原因.穿刺前详细询问病史,进行大体检查,精确选择穿刺部位,穿刺时仔细体会针感及重复针吸是减少假阴性的主要手段.     

448例乳腺肿块细针吸取细胞学诊断分析

目的:探讨细针吸取细胞学(fine needle aspiration cytology FNAC)对乳腺肿块的诊断价值,提高其诊断准确率.方法:回顾性分析湖北省荆州市肿瘤医院病理科细胞室2004年9月-2007年9月间448例有术后组织病理学诊断证实的乳腺肿块FNAC资料.结果:FNAC诊断敏感度96.1%,特异度96.9%,假阴性率3.9%,假阳性率3.1%,总准确率96.7%,穿刺取材成功率99.33%, 乳腺癌明确诊断率 75.97%;急性乳腺炎、乳腺囊肿、乳汁潴留囊肿、男性乳腺发育和大部分乳腺纤维腺瘤特异度100%且能确定组织学类型.结论:FNAC对乳腺肿块良恶性质的诊断准确率很高,对一些乳腺癌诊断准确,可以部分替代乳腺癌术中冰冻切片,对部分良性肿块可以确定组织学类型.     

乳腺针吸细胞学检查在乳腺肿瘤诊断中的应用价值

目的 探讨乳腺针吸细胞学(FNAC)检查对乳腺肿瘤诊断的准确性及应用价值.方法 对1193例乳腺疾病患者进行FNAC检查,按照FNAC诊断标准进行分级诊断;并将其中267例患者的组织病理学检查结果与FNAC检查结果进行对比分析.FNAC分级诊断结果与患者的年龄、肿瘤部位及大小之间的相关性分析采用χ2检验.结果 1193例患者中,FNAC诊断:I级886例(74.3%);II级228例(19.1%);III级44例(3.6%);IV级35例(2.9%).乳腺FNAC阳性检出率(III级+ IV级)与患者的年龄、肿瘤部位及大小无显著相关性.FNAC检查对乳腺恶性肿瘤诊断的敏感性为92.9%(79/85),特异性为100%(182/182);阳性似然比趋向无穷大,阴性似然比为0.07,Youden指数为0.93;假阴性率为7.0%(6/85),无一例假阳性.结论 乳腺FNAC诊断乳腺恶性肿瘤的准确性高,对临床诊断、治疗有一定指导意义.     

323例乳腺肿块针吸细胞学诊断分析

目的 探讨乳腺癌针吸细胞学(FNAC)诊断准确性。方法 分析1326例乳腺肿块针吸细胞学诊断,并与323例手术后病理组织学诊断结果对比。结果 本组FNAC诊断敏感性为97.1％,特异性为97.3％,假阳性率为2.7％,假阴性率为2.9％,诊断符合为97.2％。结论 乳腺肿块FNAC检查是一种实用价值很高的诊断方法。文中对影响FNAC诊断的因素进行了讨论。     

448例乳腺肿块细针吸取细胞学诊断分析

目的：探讨细针吸取细胞学（fine needle aspiration cytology FNAC）对乳腺肿块的诊断价值,提高其诊断准确率。方法：回顾性分析湖北省荆州市肿瘤医院病理科细胞室2004年9月-2007年9月间448例有术后组织病理学诊断证实的乳腺肿块FNAC资料。结果：FNAC诊断敏感度96．1％,特异度96．9％,假阴性率3．9％,假阳性率3．1％,总准确率96．7％,穿刺取材成功率99．33％,乳腺癌明确诊断率75．97％;急性乳腺炎、乳腺囊肿、乳汁潴留囊肿、男性乳腺发育和大部分乳腺纤维腺瘤特异度100％且能确定组织学类型。结论：FNAC对乳腺肿块良恶性质的诊断准确率很高,对一些乳腺癌诊断准确,可以部分替代乳腺癌术中冰冻切片,对部分良性肿块可以确定组织学类型。     

乳腺肿块针吸细胞学检查157例报告

目的　探讨针吸细胞学在乳腺肿块中的诊断价值。方法　对本组中阳性、假阳性和未确定的细胞涂片进行了复查并与石蜡切片进行了对比分析。结果　 72例乳腺癌中 ,针吸细胞学诊断 6 1例 (84 7% )。 6例假阴性 (8 3 % ) ,85例良性病变通过针吸细胞学诊断 80例 (94% )。 2例假阳性 (2 4% )。 8例未明确定性 (5 1% )。结论　针吸细胞学检查是确诊乳腺肿块性质的有效方法。     

Ultrasound (US) diagnosis of nonpalpable breast cancer

BACKGROUND: Ultrasound (US) is a standard modality to diagnose breast diseases. To elucidate the usefulness of US in the diagnosis of nonpalpable breast cancers, we reviewed the cases that were treated at our institution. METHODS: Of the 106 cancers that were operated upon at the Tsukuba University Hospital between February 2004 and March 2005, 12 cancers were nonpalpable. We reviewed their US findings, results of US-guided fine needle aspiration cytology (FNAC), core biopsy results, and histological diagnoses. RESULTS: On US, 9 tumors appeared as masses. The US observations were valuable, but a confirmatory diagnosis could not be made. US-guided FNAC was performed in 8 cases; malignancy was suspected in 6 cases. US-guided core biopsy was performed in 9 cases, and it was diagnostic in 7 cases. CONCLUSIONS: Nonpalpable breast cancers can be effectively detected by US, and the diagnosis can be confirmed by US-guided FNAC or core biopsy.     

全视野数字化乳腺摄像与细针穿刺细胞学检查对乳腺肿块的诊断意义

目的评估细针穿刺活检与数字化乳腺摄像在乳腺肿块定性诊断中的准确性。方法102例乳腺肿块患者(年龄17～76岁,中位年龄50岁)均进行细针穿刺活检与数字化乳腺摄像检查,且所有患者均入院手术获得病理诊断,所得结果与最终的病理学诊断结果进行对照分析。结果102例患者中,最终病理确诊为乳腺癌者43例(42.2%),细针穿刺活检对乳腺癌检测的敏感性为90.7%(39/43),特异性为89.8%(53/59),总准确率为90.2%(92/102)。数字化乳腺摄像检查对乳腺癌的敏感性也是88.4%(38/43),而特异性是83.1%(49/59),总的准确率是85.3%(87/102)。细针穿刺活检假阴性的乳腺癌可通过数字化乳腺摄像检查得到正确诊断。结论细针穿刺活检与数字化乳腺摄像都是诊断乳腺疾病的准确有效方法,两者联合应用能够降低乳腺肿块的误诊率。     

Evaluation of fine-needle aspiration cytology of breast masses in males

BACKGROUND: The reliability of fine-needle aspiration cytology (FNAC) of breast masses in males could be compromised by lack of experience because breast carcinoma is rare in males and FNAC is not often used. In addition, FNAC of the more often encountered gynecomastia may lead to overdiagnosis. Therefore, in the current study the authors evaluated their experience with FNAC of breast masses occurring in males. METHODS: A total of 153 FNACs of the male breast obtained between 1985 until the end of 2000 were retrieved from the electronic files of the study institution. A total of 141 FNACs were taken from unilateral lesions in men age > 24 years, the group of men believed to be most at risk for breast carcinoma. Histologic follow-up was retrieved from the same files and was available for 72 FNACs. For specimens without histologic follow-up the nationwide pathology database was consulted and no cases of breast carcinoma were found. RESULTS: The inadequate rate was 13%. When inadequate FNACs were included in the calculations, the sensitivity was found to be 87% and the specificity 78%. When the inadequate FNACs were excluded from the calculations the sensitivity was reported to be 100% and the specificity 89%. The positive predictive value of a diagnosis of malignancy was 100%. During the study period the authors' institution examined approximately 10,000 FNAC specimens from male and female breasts and 399 resection specimens from the breasts of men age > 24 years with unilateral lesions. In this last group, preoperative FNAC reduced the benign-to-malignant ratio from 19.8:1 to 3.5:1. CONCLUSIONS: FNAC of the male breast is a reliable procedure in a setting in which sufficient numbers of FNACs of the breast are examined. The authors believe FNAC should be used more often in the preoperative evaluation of breast lesions occurring in males.     

Fine needle aspiration cytology and breast cancer diagnosis

The authors report on 315 histologically confirmed consecutive breast cancer (BC) cases undergoing fine needle aspiration cytology (FNAC). Inadequate smears were infrequent (7%), particularly when reaspiration of inadequate cases was employed (1-2%). FNAC suspected BC in 81% of the total or 88% of adequate smears. Univariate and multivariate (Cox's model) analyses showed no correlation between inadequacy or suspect/positive FNAC rate and patient age, T category or histologic type. Differences in the inadequacy and suspect/positive rate were recorded among 30 operators (surgeons, oncologists, radiologists) performing the sampling, but the average results were consistent with literature reports. FNAC was found to be a useful diagnostic tool for BC diagnosis, and proper training of the highest number of operators is recommended to allow the widest diffusion of this diagnostic technique.     

Accuracy of Fine Needle Aspiration Cytology in Head and Neck Masses

In ENT clinical practice patients with neck swelling is a common presentation. To know their exact nature a simple, sensitive and diagnostic tool is required to prevent unnecessary costlier investigation and corresponding treatment. Fine needle aspiration cytology (FNAC) is a very safe, sensitive and diagnostic tool. This study was done to know the diagnostic accuracy, sensitivity and specificity of the FNAC in head and neck masses. Present prospective study was done in 179 patients of head and neck masses which were subjected to FNAC and their results were later correlated with histopathological examination report (HPR) wherever available. Out of 179 FNAC, HPR available only in 152 cases. In present study 104 cases (58.10 %) of lymph node, 35 cases (19.55 %) of thyroid gland, 17 cases (9.49 %) of salivary gland, 12 cases (6.70 %) of soft tissue and 11 cases (6.14 %) of miscellaneous swellings were present. The sensitivity, specificity, positive predictive value and negative predictive value of present study were 81.8, 95.0, 81.8 and 95.0 % respectively. The accuracy was 92.10 %.