绝经后乳头溢液164例分析

目的探讨绝经后乳头溢液的病因和诊断方法。方法回顾性分析164例绝经后乳头溢液患者临床资料。结果肿瘤性乳头溢液123例中乳管内乳头状瘤78例,乳头状瘤病24例,乳腺癌21例。乳管扩张症12例,乳管慢性炎症29例。乳头溢液脱落细胞检查诊断乳腺癌的阳性率57%;选择性乳管造影检查对乳管肿瘤性病变诊断的阳性率为93.4%,对乳腺癌诊断的阳性率为85.7%;乳管镜检查对乳管肿瘤性病变诊断的阳性率97%,对乳腺癌诊断的阳性率为92.3%。良性肿瘤采用局部切除术治疗69例,乳腺区段切除治疗41例;乳腺癌应用保乳手术治疗4例,根治手术治疗17例。结论绝经后乳头溢液患者乳头状瘤和乳腺癌发生率较高。选择性乳管造影和乳管镜检查对乳头溢液的病因诊断有重要价值。

Analysis of 164 Cases of Postmenopausal Nipple Discharge

Objective To explore the cause and diagnosis method of postmenopausal nipple discharge.Methods The clinical data of 164 cases of postmenopausal nipple discharge were analyzed retrospectively.Results In 123 cases of benign or malignant tumor,78 cases were diagnosed as intraductal papilloma,24 cases as papillomatosis,21 cases as breast cancer.Besides,12 cases were diagnosed as mastoplasia and 29 cases as chronic galactophoritis.The positive rate of nipple discharge exfoliative cytology for breast cancer was 57%;selective galactography for intraductal papillary lesions was 93.4%,for breast cancer was 85.7%;breast duct endoscope for intraductal papillary lesions was 97%,for breast cancer was 92.3%.Benign tumor was cured by local resection in 69 cases and mammary gland sector resection in 41 cases.Breast cancer was cured by lumpectomy and axillary dissection in 4 cases and by radical operation in 17 cases.Conclusion The prevalence rate of papilloma and breast cancer is higher in patients of postmenopausal nipple discharge.Selective galactography and breast duct endoscope are of great value in the diagnosis of nipple discharge.