对乳腺肿物针吸细胞学诊断标准的探讨——951例细胞学与组织学的对照分析

目的：探讨乳腺肿物针吸细胞学检查（FNAC）的基本形态学要素及拟定的诊断标准的可靠性与局限性。方法：对4309例患者行FNAC检查,其中951例获得组织病理学核对。结果：413例针吸涂片中,多数性质相同的病例显示具有相对一致的形态学变化特征。732例恶性肿瘤诊断的敏感性为97．3％,219例良性病变诊断的特异性为97．7％,总准确率为97．4％;假阴性率为2．7％,潜在假阳性率为2．3％,无1例假阳性,总误诊率为2．6％。结论：（1）导管上皮细胞分化、排列方式以及良性裸核细胞的数量是分析乳腺肿物FNAC形态学变的3个基本要素。（2）拟定的乳腺肿物FNAC诊断标准检查结果可靠性很强;但仍存在一定的局限性,需要通过病理组织学诊断解决。

Study on diagnostic standards for fine needle aspiration cytological diagnosis of breast masses: a comparative analysis of cytology and histology of 951 cases

Objective To study the basic morphological factors and the reliability and limitations of the diagnostic standards of fine needle aspiration cytology (FNAC) of breast masses which drafted. Methods A total of 4 309 fine needle aspiration biopsy cases of breast were performed and 951 cases of which were checked with their histological diagnosis. Results Of the 413 aspiration smear studies, relatively identical morphological features were found on the smears of lesions of the same nature. The sensitivity of diagnosis of malignant tumor in 732 cases, the specificity of diagnosis of benign lesion in 219 cases and the overall accuracy of diagnosis were 97 3% , 97.7%, and 97.4% respectively. The false negative rate, potential false positive rate and the overall misdiagnosis rate were 2.7%, 2 3% and 2.6% respectively, no false positive diagnosis case was found. Conclusions (1) The differentiation and the arrangement pattern of the tubular epithelial cells and the amount of benign naked nuclear cells are the three essential factors in the analysis of morphological changes of FNAC of breast mass. (2)The examination of our diagnostic standards of FNAC of breast masses shows that the standards are very reliable but have certain limitations which need to be resolved by histopathological diagnosis.