摘要
目的总结乳腺癌细针穿刺的细胞形态学特点及鉴别诊断。方法观察175例乳腺癌细针穿刺的细胞学涂片与76例乳腺增生症、93例乳腺纤维腺瘤对照分析；同时观察20例细胞学漏诊和低诊乳腺癌细胞学涂片与13例细胞学过诊病例对照分析。结果175例乳腺癌：细胞排列杂乱无极性96．6％（169／175），核间疏松排列71．4％（125／175），以散在或小细胞群为主34．3％（60／175），核中等大小以上81．1％（142／175），圆形细胞核占绝大多数88．6％（155／175），核边缘不整齐28．6％（50／175），核质比明显增大60％（105／175）、明显减小8．6％（15／175），大核仁28％（49／175），核大小差异明显77．7％（136／175），未见肌上皮细胞96％（168／175），可见坏死13．7％（24／175），散在细胞圆形核占绝大多数89．7％（157／175）、胞质完整66．9％（117／175），均明显高于乳腺增生症、乳腺纤维腺瘤的相对病例数，差异均有统计学意义（P〈0．05）；细胞数量多的、散在细胞中等量以上的分别为52．6％（92／175）、55．4％（97／175），均明显高于乳腺增生症的5．3％（4／76）、14．5％（11／76），均P〈0．05。20例细胞学漏诊、低诊乳腺癌：圆形核细胞占绝大多数、胞质完整均为70％（14／20），易见腺腔、腺管、炮竹、栅栏、单列纵队等特殊排列为35％（7／20），均明显高于13例细胞学过诊病例相对病例数，差异有统计学意义（P〈0．05）。结论乳腺癌细针穿刺的细胞形态学特点有：细胞数量较多，呈松散、紊乱样排列，以散在和（或）小细胞群为主；胞质完整；核增大，呈圆形或不规则圆形，边缘不整齐，核质比明显增大或减小，核仁增大，核大小差异明显；易见散在细胞，未见肌上皮细胞，可见坏死；与乳腺增生症、乳腺纤维腺瘤可以鉴别。圆形核细胞占绝大�
Objective To summarize the cytological features of breast carcinoma by fine needle aspiration and differential diagonsis of breast hyperplasia and breast flbroadenoma. Methods Cytological features about 175 cases of breast cancer were analyzed,contrasted with 76 cases of breast hyperplasia and 93 cases of fibroadenoma. And 20 cases of low-diagnosis breast cancer were analyzed, compared with 13 cases of excessive diagnosis. Results The followings were found：disorderly arranged cells in 169 cases of breast cancer, about 96.9% in 175 cases,loose distance between the nucleus in 125 cases of all cases （ about 71.4% ）. The percentage of small groups or scattered cells, medium size cells, round nucleus and irregular border nucleus was 34.3% （60/175） ,81.1% （142/175）, 88.6% （155/175） and 28.6% （50/175） respectively. The nucleus/ cytoplasm ratio was increased in 105 cases of all （ about 60% ）. The nucleus/cytoplasm ratio was obviously reduced in 15 cases of all （ about 8.6% ）. Big nucleolis were observed in 49 cases of all （ about 28% ）. There was significant difference between nucleus size in 136 cases of all （about 77.7% ）. There was not myoepithelial cell in 168 cases of all （about 96% ）. The percentage of visible necrosis,scsttered round nucleus and integrity of cytoplasmic was 13.7% （24/175）, 89.7% （ 157/175 ）, 66.9% （ 117/175 ） respectively. The cases of all above features were significantly more than those of breast hyperplasia and breast fibroadenoma （ P 〈 0.05 ）. The percentage of large number of cells was 52.6% in 175 breast cancer cases, higher than 5.3% in 76 breast hyperplasia cases. There was a significant difference（ P 〈 0.05 ） between two groups. In 20 cases of low-diagno- sis breast Cancer the percentage of round nucleus with integrity of cytoplasmic, special arrangement cells was 70% （14 cases） ,35% （7 cases） ,higher than the cases in 13 excessive diagnosis cases. There was a significant difference（P 〈 0.05） between two group
出处
《国际肿瘤学杂志》
CAS
2011年第4期310-315,共6页
Journal of International Oncology
关键词
乳腺肿瘤
细针穿刺
细胞病理学
诊断
鉴别
Breast neoplasms
Fine needle aspiration biopsy
Cytopathology
Diagonsis, differential
