CAJ | 학술논문

目的提高乳腺核芯针穿刺病理诊断的准确性.方法回顾性观察解放军总医院病理科2004年1月至2007年6月667例超声引导下乳腺核芯针穿刺连续病例,主要以先行核芯针穿刺活检,随后切除病变的患者为研究对象,对比核芯针穿刺与手术切除标本的病理形态,分析诊断差异的原因.结果 382例核芯针穿刺后行局部病变切除、保乳手术和乳房切除术,切除手术后病理诊断为恶性者281例,其中假阴性4例,假阴性率为1.4%.无假阳性病例.低估者28例,导管原位癌低估者为6/11,高估者2例.核芯针穿刺诊断的准确率为94.7%(266/281).结论了解乳腺核芯针穿刺取材的局限性,善用免疫组织化学指标,掌握少见病变,才能减少低估和高估病例、杜绝假阳性病例.病理医师应在保证诊断准确的前提下,尽可能细化诊断.
목적 제고유선핵심침천자병리진단적준학성.방법 회고성관찰해방군총의원병이과2004년1월지2007년6월667례초성인도하유선핵심침천자련속병례,주요이선행핵심침천자활검,수후절제병변적환자위연구대상,대비핵심침천자여수술절제표본적병리형태,분석진단차이적원인.결과 382례핵심침천자후행국부병변절제、보유수술화유방절제술,절제수술후병리진단위악성자281례,기중가음성4례,가음성솔위1.4%.무가양성병례.저고자28례,도관원위암저고자위6/11,고고자2례.핵심침천자진단적준학솔위94.7%(266/281).결론 료해유선핵심침천자취재적국한성,선용면역조직화학지표,장악소견병변,재능감소저고화고고병례、두절가양성병례.병리의사응재보증진단준학적전제하,진가능세화진단.
Objective To evaluate the diagnostic accuracy of ultrasound-guided core needle biopsy of breast tumors. Methods Six hundred and sixty-seven cases of core needle biopsy of breast encountered during the period from January, 2004 to June, 2007 were retrieved from the archival file and retrospectively reviewed. The core needle biopsy diagnoses were correlated with the histologic findings of the subsequent surgical excision specimens. The discrepancies were further analyzed. Results Three hundred and eightytwo patients had core needle biopsy diagnosis followed by local excision, breast conservation surgery or mastectomy. Two hundred and eighty-one cases were confirmed to have malignancy in the surgical specimens. Review of the corresponding core needle biopsies showed 4 false-negative cases, no false-positive cases, 28 cases with underestimation and 2 cases with overestimation. The false-negative rate was 1.4% (4/281). The rate of underestimation for ductal carcinoma-in-situ was 6/11. The diagnostic accuracy of core needle biopsy was 94.7% (266/281). Conclusion In order to improve the diagnostic accuracy of core needle biopsy of breast tumors, recognition of the limitation of the procedure, application of immunohistochemistry and awareness of potentially rare entities are important.