乳腺导管内隆起性病变的临床分析

目的 总结乳腺导管内隆起性病变在乳腺导管镜检查时的表现类型,指导临床对病变性质的判定.方法 对北京市大兴区妇幼保健院2009年1月至2013年1月的382例乳头溢液患者行乳腺导管镜检查,发现乳腺导管镜内隆起性病变153例（40.9％）,均进行手术,分析乳腺导管镜诊断与病理组织学诊断的相互关系.结果 153例隆起性病变的镜下诊断：乳管内乳头状瘤124例,乳管内乳头状瘤病11例,乳腺导管内癌1例,浆细胞性乳腺炎伴局部增生17例.术后病理诊断：乳管内乳头状瘤122例,乳管内乳头状瘤恶变1例,乳管内乳头状瘤病11例;乳腺导管内癌1例,局部导管上皮增生3例（其中不典型增生1例）,浆细胞性乳腺炎伴局部导管上皮增生15例.镜下诊断符合率：乳管内乳头状瘤98.4％;乳管内乳头状瘤病100.0％;乳管内癌100.0％;浆细胞性乳腺炎伴局部导管增生88.2％.结论 乳腺导管镜对乳管内隆起胜病变大部分能做出正确诊断,但应警惕癌前病变及恶变的误诊和漏诊.

Clinical analysis of breast intraductal eminence lesions

Objective To observe the types of breast intraductal eminence lesions.Methods Three hundred and eighty-two patients with no breast milk sample of nipple discharge were examined using ductoscopy in Daxing materal and child health hospital in Beijing city from January 2009 to January 2013.Of them 153 patients were found suffering intraductal eminence lesions （40.9% of nipple discharge） and were treated with operation.Results The ductoscopy diagnosis of 153 patients with eminence lesions was as follows：124 cases of intraductal papilloma,11 cases of intraductal papillomatosis,1 case of intraductal carcinoma; 17 cases ofplasma cell mastitis with local hyperplasia.Post operation pathological diagnosis was as follows：122 cases of intraductal papilloma,1 case of intraductal papilloma with malignant transformation,11 cases of intraductal papillomatosis,1 case of intraductal carcinoma,3 cases of local duct epithelium hyperplasia,15 cases of plasma cell mastitis with local duct epithelium hyperplasia.The accordance rate of mammary ductoscopy diagnosis was as follows：intraductal papilloma was 98.4% ; intraductal papillomatosis was 100.0% ; intraductal carcinoma was 100.0% ; plasma cell mastitis with local duct epithelium hyperplasia was 88.2%.Conclusion Mammary ductoscopy can make correct diagnosis for most breast intraductal eminence lesions,but the misdiagnosis may cause malignant transformation.