临床不可触及乳腺病变超声引导下空芯针穿刺活检的临床应用

目的评价超声引导空芯针穿刺活检（US-CNB）在临床不可触及乳腺病变术前诊断中的应用价值。方法收集行超声引导空芯针穿刺活检的临床不可触及的乳腺病变患者46例,结合手术后病理切片,对空芯针穿刺活检标本和开放性活检（EP）标本的病理组织学诊断进行比较和分析。结果 46例患者经US-CNB诊断为乳腺腺病32例,纤维腺瘤8例,导管上皮增生4例,导管上皮不典型增生1例,导管内癌1例,导管内癌伴早期浸润1例。22例未做手术,随访至今无疾病进展。24例行开放性活检手术,US-CNB与开放性活检的病理诊断符合率为91.7%,kappa=0.921（P〈0.01）.US-CNB病理诊断的敏感性为95.8%,特异性为100%,假阴性4.16%,无假阳性。结论对于临床不可触及肿块的乳腺病变,超声引导下空芯针穿刺病理学检查是可靠的诊断方法,US-CNB诊断为非肿瘤性病变的患者可免于开放性手术,长期随访。

Clinical application of ultrasound-guided core needle biopsy in nonpalpable breast lesions

Objective To evaluate the clinical value of ultrasound-guided core needle biopsy （ US-CNB） for nonpalpable breast lesions as a preoperative diagnostic modality.Methods Data were collected from August 2007 to May 2009 for 46 ultrasound-guided core needle biopsy for nonpalpable breast lesions that were followed by excision breast procedure （ EP） at our hospital.The his-topathological diagnosis on ultrasound-guided core needle biopsy was then compared with the findings of the excision biopsy.Results Out of the total 46 cases,US-CNB showed 32 as adenosis of breast,eight fibroadenoma,four ductal hyperplas of mammary,one atypical ductal hyperplas of mammary,one ductal carcinoma in situ,one early invasive ductal carcinoma.22 cases hadn＇t been operated,which no progression of disease at present.The principle histology identified at CNB was confirmed at EP for 91.7% of the lesions,generating a kappa value of 0.921 （ P0.01） .The sensitivity for malignancy with CNB was 95.8% and the specificity was 100% .The false negati-ve rate was 4.16% and the false positive rate was 0.Conclusions Ultrasound-guided core breast biopsy is a satis-factory procedure for the histopathological diagnosis of nonpalpable breast lesions.If the histopathological diagnosis of ultrasound-guided core breast biopsy is not tumor,these patients would not need excision breast procedure （ EP） , should be followed up for long time.