乳管内视镜在诊断伴乳头溢液的乳腺癌中的应用

目的：研究乳腺导管内视镜在诊断伴乳头溢液的乳腺癌方面的临床应用价值。方法：1997年10月-1999年8月共对393例乳头溢液患者进行乳管内视镜检查，其中发现乳腺癌11例，对此11例患者的乳管内镜下表现进行研究及随访。结果：乳管内视镜下乳腺癌具有较特异的管壁及管腔改变。如斑片样隆起和异常出血。新生物的表现似无特征性。乳管内视镜诊断的敏感度为82%（9/11），特异度为98.7%。由于乳管镜的定位使得５例未Men及肿块的患者也顺利的进行了手术活检。且病理证实皆为导管内癌（DCIS）伴或不伴灶性浸润。结论：乳管内视镜在诊断乳腺癌方面具有早期诊断、定位病灶、引导活检等多方面应用价值。对于乳管内视镜发现的可疑病灶应该进一步尽早取得组织学确诊。

Application of duct endoscopy in the early diagnosis of breast cancer with nippledischarge

Purpose:To evaluate the significance of duct endoscopy on the early diagnosis of breast cancer with nipple discharge. Methods:From Oct. 1997 to Aug.1999,11 cases of breast cancer were found in 393 patients who underwent duct endocopy for nipple discharge. These 11 cases were followed up, and their endoscopic presentation were reported. Results:The presentation of ductal cancer under duct endoscopy was characterized by irregularity of the duct wall and the lumen, such as patch like elevation and aberrant bleeding. However,the presentation of a ductal neoplasm had no particularity. The diagnostic sensibility and specificity of duct endoscopy on breast cancer was 82%(9/11) and 98.7%, respectively. All patients received sugical biopsy. 5 non palpable breast cancers, who received surgical biopsy were located by ductoscopy and diagnosed as DCIS with/without micro invasion. Conclusions:Through duct endoscopy, breast cancer can be diagnosed early due to the finding of intraductal change on duct wall and lumin. We can also succeed in locating the malignant lesion and carrying out biopsy directly by using duct endoscopy. The highly suspecious lesion found by duct endoscopy should be further confirmed by histological diagnosis.