超声引导下穿刺活检对BI-RADS分级4A至4C乳腺肿物诊断的价值

发布时间：2018-06-08 16:05

本文选题：超声检查 + 穿刺活检　；参考：《中国肿瘤临床》2017年02期

【摘要】：目的:探讨超声引导下穿刺活检(ultrasound guided-core needle biopsy,US-CNB)在乳腺癌定性诊断中的临床应用价值。方法:选取2015年3月至2015年10月355例就诊天津医科大学肿瘤医院经乳腺超声检查结果为BI-RADS分级4A~4C的单发肿物患者资料,入选患者均行US-CNB,并与术后病理结果对照。结果:355例乳腺肿物患者的US-CNB病理结果中235例恶性肿物的术后病理均为乳腺癌,120例良性肿物患者中41例术后病理为乳腺癌。US-CNB在BI-RADS分级4A~4C患者中诊断乳腺癌的特异度均为100%,灵敏度分别为62.50%、82.46%、89.73%,准确率分别为84.62%、87.01%、90.74%。41例US-CNB假阴性患者的术后病理为14例导管内癌、5例导管内乳头状癌、3例黏液腺癌、19例浸润性导管癌。结论:US-CNB对BI-RADS分级4B~4C乳腺肿物的定性诊断是一种安全、可靠且较为准确的检查方法,但对于4A患者灵敏度较低,需慎重选择并结合钼靶、MRI等检查。超声诊断提示导管内乳头状肿瘤,不建议行US-CNB。
[Abstract]:Objective: to evaluate the clinical value of ultrasound guided-core needle biopsysyUS-CNB in qualitative diagnosis of breast cancer. Methods: 355 patients who were admitted to Tianjin Medical University Cancer Hospital from March 2015 to October 2015 were selected as single tumor patients with BI-RADS grade of 4AZ4C. All patients were selected for US-CNB, and the results were compared with postoperative pathological results. Results among the US-CNB pathological results of 355 patients with breast tumor, 235 cases of malignant tumor were diagnosed as benign tumor of breast cancer. Of the 120 cases of benign tumor, 41 cases had postoperative pathology of breast cancer. US-CNB was the specificity of diagnosis of breast cancer in patients with BI-RADS grade 4A4C. The sensitivity was 62.50 and 82.46 and 89.73, respectively. The accuracy was 84.62 and 87.010.74.41 cases of US-CNB false negative were diagnosed as intraductal carcinoma (n = 14), intraductal papillary carcinoma (n = 5), mucinous carcinoma (n = 3), invasive ductal carcinoma (n = 19). Conclusion the qualitative diagnosis of BI-RADS grade 4BX 4C mammary gland tumor with the ratio of: US-CNB is a safe, reliable and accurate method, but the sensitivity of 4A patients is low, so it is necessary to choose carefully and combine with MRI examination of molybdenum target. Ultrasonic diagnosis of intraductal papillary tumors is not recommended.
【作者单位】：天津医科大学肿瘤医院乳腺一科国家肿瘤临床医学研究中心乳腺癌防治教育部重点实验室天津市肿瘤防治重点实验室;天津市黄河医院外科;
【分类号】：R737.9

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