乳管镜下乳腺导管冲洗液脱落细胞学检查对乳头溢液的诊断价值

目的:评价乳管镜下乳腺导管冲洗液脱落细胞学检查对乳头溢液的诊断价值.方法:2003年7月至2004年10月对76例乳头溢液患者行脱落细胞学检查,同时在乳管镜下对溢液乳管异常部位搔刮,盐水冲洗,收集导管中洗液行脱落细胞学检查.结果:乳管镜诊断导管扩张或炎症30例,未行手术;乳管隆起性病变46例,行手术活检;病理诊断早期乳腺癌10例,管内乳头状瘤32例,乳腺腺病4例.76例中,导管冲洗液涂片的有效细胞团较乳头溢液明显增加(P＜0.01).10例早期乳腺癌导管冲洗液脱落细胞学检查的准确性明显高于乳头溢液细胞学检查(P＜0.05).结论:乳管镜下乳腺导管冲洗液涂片能获得更多的有效细胞团,使导管冲洗液细胞学检查诊断乳腺恶性病变的准确性明显提高.

Diagnostic Value of Nipple Discharge in Exfoliative Cytology for Ductoscopic Ductal Lavage

Objective: To study the diagnostic value of nipple discharge in exfoliative cytology with ductoscopic ductal lavage. Methods: A total of 76 patients with nipple discharge were examined by fiberoptic ductoscopy. Exfoliative cytology of nipple aspiration was performed before ductoscopy examination. Abnormal intraduct of breast lesions were scraped with biopsy needle under ductoscopy and then the ducts were washed with 0.9% NS solution. The ductal lavage was collected for exfoliative cytology. Results: Thirty patients with mild redness of ductal menbrance or mammary ductal ectasia were not operated. Forty-six patients with intraductal protruded lesion underwent regional excision. Pathological findings showed there ws the early breast cancer in 10 patients, papilloma in 32 and fibrocystic disease in 4. In all patients, the ductal lavage obtained more adequate specimens than nipple aspiration (P<0.01). The diagnostic accuracy of exfoliative cytology in ductal lavage was significantly higher than that of the nipple aspiration in 10 patients with early breast cancer (P<0.05). Conclusion: The results show that ductoscopic ductal lavage in nipple discharge can provide much more adequate specimens for exfoliative cytology and increase the diagnostic accuracy on nipple discharge.