纤维乳管镜对乳腺导管内肿瘤的诊断价值

目的：探讨纤维乳管内窥镜（简称“纤维乳管镜”）对乳腺导管内肿瘤的诊断价值。方法：66例单侧单孔血性乳头溢液的患者入院行手术治疗，术前均同时行纤维乳管镜检查及超声检查，回顾性分析其术前检查诊断与病理符合情况。结果：66例血性乳头溢液患者，病理证实乳腺导管内肿瘤59例（其中导管内乳头状瘤47例，导管内乳头状瘤伴上皮非典型增生4例，导管内癌8例），导管内肿瘤发生率89．39％（59／66），导管内肿瘤伴非典型增生（癌前病变）及导管内癌发生率18．18％（12／66）；单纯导管扩张症7例，发生率10．61％（7／66）。59例病理所示导管内肿瘤的患者乳管镜检查阳性57例（包括导管内乳头状瘤伴上皮非典型增生4例，导管内癌8例），阴性2例，导管内肿瘤诊断率96．61％（57／59）。超声检查阳性30例（包括导管内乳头状瘤伴上皮非典型增生1例，导管内癌3例），阴性29例，导管内肿瘤诊断率50．85％（30／59），二者比较有统计学意义（P〈0．01）。结论：血性乳头溢液患者乳腺导管内肿瘤发生率较高，纤维乳管镜检查显著提高乳腺导管内肿瘤（包括导管内癌）的诊断率，对乳腺导管内肿瘤的诊断具有重要价值。

Diagnosis of breast intraductal tumor by fiberoptic ductoscopy

Objective： To evaluate the role of fiberoptic ductoscopy in diagnosis of breast intraductal tumor. Meth- ods： Sixty - six patients with bloody nipple discharge of half single breast duct were treated by operation. Before the operation, they were all examined by fiberoptic ductoscopy and doppler ultrasound. The consistency of preoperative di- agnosis and pathology were retrospectively analyzed. Results：Among the 66 cases with bloody nipple discarge,59 ca- ses were diagnosed as intraductal tumor by pathology （47 cases as intraductal papilloma, 4 cases as intraductal papilloma with atypical hyperplasia, and 8 cases as intraductal carcinoma）. The incidence rate of intraductal tumor was 89.39% （59/66）. It was 18.18% （12/66） of intraductal papilloma with atypical hyperplasia （ in other words, as precancerosis ） and intraductal carcinoma. 7 cases were diagnosed as ductal ectasia, and the incidence rate was 10.61% （7/66）. Among the 59 cases of intraductal tumor,57 cases were diagnosed by fiberoptic ductoscopy（ in- cluding 4 cases of intraductal papilloma with atypical hyperplasia and 8 cases of intraductal carcinoma） ,30 cases were diagnosed by doppler ultrasound （including 1 case of intraductal papilloma with atypical hyperplasia and 3 cases of in- traductal carcinoma）. The consistency rate with pathological diagnosis were 96.61% （57/59） and 50.85% （30/59） respectively. There was statistical difference between them （P 〈 0.01 ）. Conclusion：The incidence rate of intraductal tumor was very high among patients with bloody nipple discarge. Fiberoptic ductoscopy improved the diagnosis rate of intraductal tumor（ including intraductal carcinoma）.