996例纤维乳管镜诊治分析

目的探讨乳管镜诊治乳管内早期病变的价值。方法2009年1月-2011年12月，采用日本FiberTeehr-FT-201型乳管镜对996例非乳汁性乳头溢液及部分无乳头溢液进行诊断、灌洗治疗、定位、活检。其中镜下植入定位针532例，灌洗治疗197例，取活检114例。结果996例乳管镜诊断乳头状瘤和乳头状瘤病697例，似乳管癌99例，乳管积液扩张123例，平坦型红斑病变4例，毛细血管扩张2例，闭塞性乳管炎50例，余21例乳管镜除乳管扩张外未见明显异常。镜下植入定位针准确扎入瘤体460例，准确率86．5％（460／532）。镜下灌洗治愈乳管炎196例，治愈率99．5％（196／197）。镜下活检成功取出瘤体组织98例，成功率86．0％（98／114）。结论乳管镜可作为诊治乳管内早期病变的首选措施，其所起到的作用是B超、钼靶所不及的。

Breast Duct Endoscopy for the Diagnosis and Treatment of Early-stage Breast-duct Disease: Report of 996 Cases

Objective To investigate effective diagnosis and treatment of early-stage breast duct diseases with breast duct endoscopy. Methods From January 2009 to December 2011, we performed breast duct endoscopy （ FiberTechr-FT-201, Japan） on 996 patients with or without non-latex nipple discharge, for diagnosing, implanting positioning pin （532 cases）, biopsy （114 cases）, and breast ductal lavage （ 197 cases）. Results Of the 996 patients, 697 were diagnosed with papilloma and papillary tumor, 99 were suspected as having ductal carcinoma, 123 patients were diagnosed with dilated duct with fluid, 4 with flat erythematous lesion, 2 with capillary dilatation, 50 with obstructive galactophoritis, and the other 21 were shown simple ductal dilation without any lesions. Implantation of positioning pin was completed accurately in 460 of the 532 patients （＇accuracy rate 86.5% ）. In the 197 patients, who underwent ductal lavage, 196 were cured （cure rate 99.5% ）. And in the patients who received biopsy, tumor tissues were harvested in 98 cases [ success rate 86.0% （98/114）]. Conclusions Breast duct endoscopy can be the first choice for diagnosing and managing early-stage breast duct diseases. It is more effective than B-ultrasonography and Mo-target mammography.