超声引导下经皮空心针穿刺组织病理学检查对乳腺病灶的诊断效果评价

目的 探讨超声引导下经皮空心针穿刺(CNB)组织病理学检查诊断乳腺病灶的临床价值.方法 回顾性分析177例乳腺病灶的超声引导下CNB病理学检查结果 ,并与术后组织病理学诊断结果 进行比较,评价CNB诊断的效果.结果 177例乳腺病灶组织中,CNB病理诊断乳腺痛129例,术后病理组织学诊断乳腺癌136例,CNB病理诊断假阴性7例.CNB病理诊断乳腺癌的灵敏度为94.9%,特异度为100%,准确率为96.0%,阳性预测值为100%,阴性预测值为85.4%,约登指数为0.949,Kappa值为0.895(P<0.01).结论 CNB组织病理诊断乳腺病灶具有较高的准确性,与术后病理组织学诊断结果 一致性较高,是一种可靠的乳腺病灶活检方法 .

Evaluation of the value of ultrasound-guided core needle biopsy in the diagnosis of breast lesions

Objective To investigate the accuracy, consistency and related affecting factors in pathological results of breast lesions diagnosed by ultrasound-guided core needle biopsy ( CNB) and conventional excision histopathology. Methods The clinical data of 177 consecutive cases of breast lesions examined by ultrasound-guided CNB and subsequently excised were reviewed from Jan. 2003 to Nov. 2009.The agreement of pathological diagnosis between the CNB and subsequent excision pathology was analyzed. Results There were 136 cancers in the final diagnosis after surgical excision among 386 breast lesions and 129 of them were diagnosed by CNB. The sensitivity (true positive) of CNB was 94.9% , false negative rate was 5.1% , specificity (true negative) was 100% , false positive rate 0, Youden's index was 0. 949,and positive predictive value and negative predictive value were 100% and 85. 4% , respectively. Condensation rate was 96.0% and Kappa value was 0. 895.Conclusion Ultrasound-guided CNB with histopathological assessment is accurate in diagnosis of breast lesions and has a great consistency with conventional excision pathology. It is a reliable method for the diagnosis of breast lesions to avoid an over-reliance on excision pathological examination.