提高乳腺肿物针吸细胞学诊断正确率措施的探讨

目的探讨提高乳腺肿物针吸细胞学（ＦＮＡＣ）诊断正确率、降低误诊率、规范诊断报告形式及充分发挥其作用的措施。方法对１６２９例病人行ＦＮＡＣ检查，其中４４４例获病理组织学核对。结果３０７例恶性肿瘤诊断的敏感性和１３７例良性病变诊断的特异性分别为９５．８％和９８．５％，总正确率为９６．６％；假阴性率为４．２％，潜在假阳性率为１．５％，无１例假阳性，总误诊率为３．４％。结论我们认为（１）使用优良的穿刺器械及制片技术，实行“一体化”工作程序，认真进行细胞学与组织学对照，对提高乳腺肿物ＦＮＡＣ诊断正确率及降低误诊率具有重要意义。（２）Ｂｅｔｈｅｓｄａ乳腺ＦＮＡＢ统一方案中提出的诊断报告形式值得借鉴。（３）ＦＮＡＣ在乳腺肿物的诊治中能够发挥出更重要的作用。

Study on measures to increase diagnostic accuracy of FNAC of breast masses

OBJECTIVE: To study the measures capable of increasing the diagnostic accuracy, reducing misdiagnosis as well as giving a full play to fine needle aspiration cytology(FNAC), in the diagnosis of breast masses, and to standardize the diagnostic report form. METHODS: Totally 1629 cases of FNAC were performed and 444 cases of them were checked with the histological diagnosis. RESULTS: The sensitivity of diagnosis of malignant tumors in 307 cases, the specificity of diagnosis of benign lesions in 137 cases and the overall accuracy of diagnosis were 95.8%, 98.5% and 96.6% respectively. The false negative rate, potential false positive rate and the overall misdiagnostic rate were 4.2%, 1.5% and 3.4% respectively, while no case of false positive diagnosis was found. CONCLUSIONS: We believe that: (1) It is very important to use a fine aspirator, to make smears of high quality, to carry out an integrated working procedure and to put into effect a conscientious check over cytological appearance with histological diagnosis. (2) The diagnositc report form introduced in "the uniform approach to breast fine needle aspiration biopsy" by Bethesda specialists is worthy of reference. (3) FNAC can further play important roles in the diagnosis and treatment of breast masses.