乳腺肿物针吸细胞学诊断漏误诊原因分析

目的：减少乳腺癌的漏、误诊，提高乳腺癌针吸细胞学诊断的准确性。方法：对36例漏、误诊乳腺针吸细胞学涂片进行病理组织学和细胞学对照分析。结果：假阴性率5．6％，穿刺技术因素占28％，细胞学诊断因素占60％。结论：提高细胞病理学诊断医师的诊断水平和针吸技术是降低漏误诊的主要措施。     

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.     

乳腺癌针吸细胞学检查假阴性15例分析

本院1997年7月～2003年12月手术治疗的乳腺癌患者中,有66例术前行针吸细胞学检查,报告为阴性者15例,导致不同程度的误诊并延误手术治疗,现就其原因分析如下.     

乳腺针吸细胞学诊断假阳性病例分析

１２５６例乳腺良性病变中有１９例（１．４８％）细胞学误诊为可疑癌、高疑癌、甚至癌。１９例中有９例（４７．４％）纤维囊性乳腺病,３例（１５．８％）纤维腺瘤,２例（１０．５％）巨大纤维腺瘤,２例（１０．５％）导管内乳共状瘤,２例（１０．５％）慢性乳腺炎和１例（５．３％）男性乳腺发育。涂片中细胞量过多或过少,细胞退变,增生活跃的导管上皮细胞有轻度异型而双极课核细胞或大汗腺化生细胞学辅助诊断成分不明确,以     

乳腺针吸细胞学诊断假阴性病例分析

探讨产生乳腺针吸细胞学诊断假阴性的原因。方法选择针吸细胞细胞学诊断假阴性病例。分析其涂片特征并与乳腺癌的常规细胞学诊断标准对照。结果：１４５９例乳腺癌中９１例针吸细胞学未能诊断。其中６６例针吸不满意,涂片中未见癌细胞;２５例误诊为良性。     

针吸细胞学在乳腺肿瘤诊断中的应用价值

本对216例乳腺病变进行了针吸细胞学检查，其中165例诊断结果与病理诊断结果对照统计无显性差异，该法具有方法简单，容易掌握，不需特殊设备，病人痛苦少，结果快速等特点，对良恶性肿瘤的鉴别诊断也具有可靠价值。     

乳腺肿块细针针吸细胞学检测800例

 目的 探讨细针针吸细胞学（FNAC）对乳腺癌的诊断意义。方法 对800例乳腺肿块患者术前用7号针头一次性10 ml注射器进行细针穿刺涂片、染色、细胞学诊断，并与术后病理诊断进行比较，观察其准确率。结果 800例术前诊断乳腺癌563例，准确率达99.47 %。结论 FNAC检测方法安全、方便、经济，准确率高，可作为乳腺肿块常规检查手段     

820例乳腺肿块针吸细胞学诊断分析

目的探讨我院乳腺肿块针吸细胞学诊断的准确率及误诊原因。方法分析820例乳腺肿块针吸细胞学检查结果,其中498例肿块切除后行组织学检查,比较针吸细胞学与病理组织学诊断结果。结果820例乳腺肿块中良性病变583例,恶性肿瘤237例,498例针吸细胞学与组织学诊断符合率为95.78%。结论乳腺肿块针吸细胞学诊断准确率高,能较准确地鉴别病变良恶性,对临床具有重要的指导意义。     

副乳腺疾病针吸细胞学诊断探讨

本文通过２４例（３９份）副乳腺疾病的针吸细胞学特征分析并与组织学诊断对比,以探讨副乳腺疾病的细胞学诊断价值,并提出副乳腺疾病的细胞学诊断要点。临床和病理资料收集我院１９９４年１月至１９９９年１月针吸标本中经组织学证实的２４例副乳腺疾病。２４例全部为女性,年龄最小为１９岁,最大为５９岁,平均年龄３２．８岁。发生部位腋前区１５例,腋窝８例,腹股沟区１例。双侧同时发生１５例,单发９例。主诉以包块为主求治者有５例,包块伴疼痛或不适者１９例。针吸方法采用１０ｍｌ一次性空针,７号针头,常规消毒穿刺、抽吸、针…     

乳腺肿物细针穿刺细胞学诊断的研究

目的　对细针穿刺细胞学诊断在乳腺肿物穿刺中的应用进行评价。方法　细针穿刺乳腺触及到实变处肿物吸取组织细胞涂片 ,采用瑞氏 -姬姆萨复合染色 ,显微镜下观察细胞排列、结构、背景特点、细胞形态等方面对乳腺肿物良恶性判定 ,并与病理组织学诊断进行对比分析。结果　乳腺肿物 3 3 2 5例细针穿刺 ,总准确率为 98 1% ;65 5例乳腺癌的诊断准确率为 10 0 % ;在部分良性病例 (乳腺纤维腺瘤 )的诊断准确率为 88% ;疑癌 94% ,描述性报告 7%确诊为乳腺癌。结论　细针穿刺细胞学诊断对于临床诊断良恶性病变有独到价值。且对恶性病例诊断更为可靠。此诊断技术简便 ,费用低 ,值得推广应用。     

针吸细胞学在淋巴结肉芽肿及反应性增生病变诊断中的应用

[目的]总结淋巴结肉芽肿病变及反应性增生在针吸细胞学中的特点．[方法]利用细针穿刺细胞学技术及薄层细胞涂片ThinPrep2000技术制作涂片。[结果]针吸细胞学诊断淋巴结肉芽肿及反应性增生病变327例，163例有组织病理学证实。细胞学诊断结核（TB）89例，肉芽肿性淋巴结炎23例，反应性增生51例，与组织病理结果对比，准确率分别为87．6％、783％、92．1％，女性肉芽肿性淋巴结炎及TB患者数量是男性的2倍；而反应性增生男性患者为女性的2倍，[结论]针吸细胞学能够对淋巴结肉芽肿及反应性增生病变做出正确诊断，减少不必要的手术活检．也使患者得到及早治疗、     

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。     

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。     

Accuracy of Fine Needle Aspiration Cytology from Breast Masses in Thailand

Objective: To evaluate the accuracy and diagnostic performance of fine needle aspiration FNA cytology indiagnoses of breast masses. Methods: Women who had FNA diagnoses for breast masses and underwentsubsequent histopathologic evaluation during January 2003-December 2006 were accessed from the archive ofthe Anatomical Pathology Department of our institution. Cytologic diagnoses were classified as unsatisfactory,benign, atypical probably benign, suspicious probably malignant, and malignant, and were compared to thehistopathologic diagnoses obtained from core needle biopsy, excisional biopsy, or mastectomy to give an assessmentof the diagnostic performance of FNA. Results: A series of 190 breast masses were identified during the studyperiod. The FNA cytological diagnosis was unsatisfactory due to inadequate specimens in eight cases (4.2%).The diagnoses in the remaining 182 cases were: benign lesions in 98 (53.9%); suspicious for malignancy in 31(17.0%); and malignant in 53 (29.1%). From the subsequent histopathologic diagnoses, 6/98 cases of benigncytology turned out to be malignant lesions (false negatives); 22/31 cases of suspicious cytology were trulymalignant while the other nine were benign; and only 1/53 with malignant cytology was benign (false positive),the lesion being a fibroadenoma . The overall accuracy, sensitivity, specificity, positive predictive value, andnegative predictive value were 91.2% (95% confidence interval [CI], 87.6%-94.8%), 92.5% (95% CI, 88.7%-96.3%), 90.2% (95% CI, 85.9%-94.5%), 88.1% (95% CI, 83.4%-92.8%) and 93.9% (95% CI, 90.4%-97.4%),respectively. Conclusions: FNA cytology is highly accurate for diagnosis of breast masses. However, the clinicianshould correlate FNA cytological results with physical examination and imaging findings to prevent false negativeand false positive events and to obtain optimal management for their patients.     

乳腺肿块针吸细胞学假阴性50例临床病理分析

目的　减少对乳腺癌的漏诊 ,降低假阴性率 ,提高针吸细胞学诊断的准确性。方法　对 5 0例假阴性乳腺肿块进行临床病理分析。结果　假阴性率 8% ,其中技术因素占 3 0 % ,病理诊断占 60 %。结论　针吸技术熟练性和病理医生诊断水平提高是降低假阴性率的主要措施     

细针吸取细胞学对甲状腺肿物的诊断价值

目的：探讨细针吸取细胞学检查对甲状腺肿物的诊断价值。方法：对有组织学证实的386例甲状腺物细针穿刺涂片进行.结果：386例甲状腺肿物细胞学检查结果与组织学检查结果相符359例,准确率为93．0％,结论：大多数甲状腺肿物在细针穿刺细胞学上可作出明确诊断。     

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。     

Detection of B-Cell Monoclonality in Fine Needle Aspiration by PCR Analysis

Cytologic examination of fine-needle aspiration (FNA) sometimes fails to diagnose the malignant nature of B-cell proliferations. In this study we analyzed the Ig gene rearrangement of 49 FNA samples by polymerase chain reaction (PCR) in order to evaluate whether molecular analyses can improve the accuracy of FNA. Twenty-six patients had non-Hodgkin's lymphoma, 11 had reactive lymphoid diseases, 5 had chronic inflammation and 7 had carcinoma. A semi-nested PCR was performed using an oligoprimer specific for consensus sequences of the V regions (FR3A) and two oligoprimers derived from conserved sequences of the J regions (LJH and VLJH). Histologic examination always followed the molecular and cytologic analysis. The sensitivity of PCR and FNA morphological examination in detecting a neoplastic pattern was 92% and 78%, respectively. When samples were considered inadequate for cytologic examination, PCR always reached a diagnosis consistent with the histologic features. Our results demonstrate that PCR analysis of FNA specimens is a reliable and sensitive method capable of enhancing the diagnostic accuracy of cytologic examination.