超声引导下穿刺活检对乳腺癌前病变的诊断价值

发布时间：2018-08-23 13:50

【摘要】：目的探讨超声引导下穿刺活检诊断乳腺癌前病变的准确性及提示病变可能被低估的超声表现。方法收集经超声引导下穿刺活检的乳腺肿物患者605例,记录肿物的超声表现,将穿刺病理结果与术后病理或随访结果进行对比。结果除3例患者因组织过少未获得穿刺病理诊断外,602例患者的穿刺病理与术后病理或随访结果对比,符合率为97.84%(589/602),两者间一致性较好(Kappa=0.96,P=0.01)。穿刺活检结果为癌前病变者与术后病理或随访结果对比符合组32例,低估组10例,低估率为23.81%(10/42)。符合组和低估组癌前病变的钙化、后方回声衰减、血流、可疑淋巴结在两组间差异有统计学意义(P均0.05)。结论超声引导下穿刺活检对诊断乳腺肿物的准确率较高,但对癌前病变存在一定低估,尤其对于超声表现有恶性特征的癌前病变应考虑低估的可能。
[Abstract]:Objective to investigate the accuracy of ultrasound guided biopsy in the diagnosis of precancerous lesions and to suggest that the lesions may be underestimated. Methods Sixty-five patients with mammary gland mass underwent ultrasound guided biopsy. Ultrasonic findings were recorded and compared with those of postoperative pathology or follow-up. Results except for 3 cases whose biopsy was not diagnosed by biopsy because of lack of tissue, the coincidence rate was 97.84% (589 / 602), and the consistency between the two was better (Kappa 0.96%, P0.01) than that of postoperative pathology or follow-up (P 0.01). The results of puncture biopsy were compared with those of postoperative pathology or follow-up in 32 cases, and 10 cases in the undervalued group, and the underestimation rate was 23.81% (10 / 42). There were significant differences in calcification, posterior echo attenuation, blood flow and suspected lymph nodes between the two groups (P 0.05). Conclusion Ultrasound-guided biopsy is accurate in the diagnosis of breast masses, but it may be underestimated for precancerous lesions, especially for precancerous lesions with malignant features.
【作者单位】：青岛大学附属烟台毓璜顶医院超声科;
【分类号】：R445.1;R737.9

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