摘要
目的探讨真空辅助旋切活组织检查(简称活检)在乳腺结节(临床不可扪及、经超声检查发现并考虑为良性疾病的低回声实性肿块称为乳腺结节)诊治中的应用价值。方法 2008年1月至2009年12月期间,广东省妇幼保健院、佛山市妇幼保健院、柳州市妇幼保健院、伊犁哈萨克自治州妇幼保健院和厦门市妇幼保健院对2 468例乳腺肿块患者进行了真空辅助旋切活检。根据纳入、排除标准,选取其中892例乳腺结节患者作为研究对象进行回顾性分析。从患者年龄、乳腺结节直径、超声BI-RADS分级和乳腺X检查与乳腺癌检出率的关系,评价真空辅助旋切活检诊治乳腺结节的价值。采用χ~2检验、Fisher确切概率检验及配对χ~2检验(McNemar检验)分析乳腺结节直径及患者年龄与病理结果的关系,乳腺癌检出率与乳腺结节直径、超声BI-RADS分级及患者年龄的关系,以及乳腺超声联合X线检查对不同BI-RADS分级乳腺结节的乳腺癌检出率差异。结果 892例乳腺结节患者共完全切除1 626个乳腺结节,检出乳腺癌16例,占1. 8%(16/892)。乳腺结节直径≥1. 5 cm者乳腺癌检出率明显高于<1. 5 cm者[6. 0%(5/84)比1. 4%(11/808),χ~2=6. 685,P=0. 010];亚组分析显示,乳腺结节直径<1. 5 cm组中年龄≥40岁者乳腺癌检出率明显高于年龄<40岁者[2. 4%(9/370)比0. 5%(2/438),χ~2=5. 831,P=0. 016)。乳腺超声BI-RADS 2级患者未检出乳腺癌;乳腺超声BI-RADS 3级患者中,乳腺结节直径≥1. 5 cm者乳腺癌检出率明显高于<1. 5 cm者[5. 4%(3/56)比1. 1%(6/565),χ~2=3. 917,P=0. 039];乳腺超声BI-RADS 3级且乳腺结节直径<1. 5 cm组中,年龄≥40岁者乳腺癌检出率明显高于<40岁者[2. 3%(6/256)比0(0/309),χ~2=5. 259,P=0. 022];乳腺超声BI-RADS 4A级患者乳腺癌检出率与年龄及乳腺结节直径无关(χ~2<0. 001,P=1. 000; P=0. 162)。在本组患者中,乳腺超声联合X线检查评估为BI-RADS 4A级者,其乳腺癌检出率明显高�
Objective To explore the clinical value of vacuum-assisted biospy in the diagnosis and treatment of breast nodules(clinically non-palpable solid mass with low-level echo in ultrasound,regarded as benign lesions).Methods From January 2008 to December 2009,2 468 patients with breast nodules from Women and Children’s Hospital of Guangdong Province,Women and Children’s Hospital of Foshan City,Women and Children’s Hospital of Liuzhou City,Women and Children’s Hospital of Ili Kazak Autonomous Prefecture,Women and Children’s Hospital Women of Xiamen City underwent vacuum-assisted biopsy.According to the inclusion and exclusion criteria,892 cases of breast nodules were enrolled in this retrospective study.The relationship of patient age,lesion diameter,ultrasound BI-RADS grade,breast X-ray findings with detection rate of breast cancer was analyzed to evaluate the application of vacuum-assisted biopsy in the diagnosis and treatment of breast nodules.The relationship between lesion diameter/patient age and the pathological results,between mass diameter/ultrasonic BI-RADS grade/patient age and detection rate of breast cancer were analyzed byχ^2 test and Fisher’s exact probability test.Pairedχ^2 test(McNemar test)was used to analyze the detection rate of breast cancer by breast ultrasound combined with X-ray scanning in patients with breast nodules at different BI-RADS grades.Results A total of 1 626 breast masses were removed from 892 patients,including 16 cases of breast cancer(1.8%,16/892).The detection rate of breast cancer in patients with lesion diameter≥1.5 cm was significantly higher than that in patients with lesion diameter<1.5 cm[6.0%(5/84)vs 1.4%(11/808),χ^2=6.685,P=0.010].The subgroup analysis showed that among the patients with lesion diameter<1.5 cm,the detection rate of breast cancer in patients≥40 years was significantly higher than that in patients<40 years[2.4%(9/370)vs 0.5%(2/438),χ^2=5.831,P=0.016].No breast cancer was detected in the patients with BI-RADS grade 2 nodules.Among the pa
作者
王永南
张安秦
连臻强
李文萍
余海云
王颀
Wang Yongnan;Zhang Anqin;Lian Zhenqiang;Li Wenpin;Yu Haiyun;Wang Qi(Breast Disease Center,Women and Children’s Hospital of Guangdong Province,Guangzhou 511400,China)
出处
《中华乳腺病杂志（电子版）》
CAS
CSCD
2018年第6期346-351,共6页
Chinese Journal of Breast Disease(Electronic Edition)
基金
佛山市妇幼保健院乳腺科
柳州市妇幼保健院乳腺科
伊犁哈萨克自治州妇幼保健院乳腺科
厦门市妇幼保健院乳腺科对本研究的大力支持
