CAJ | 학술논문

目的探讨钼靶X线对指导乳腺无肿块型簇状钙化离体标本术中病理取材的价值.方法 65例常规钼靶X线乳腺摄影显示无明显肿块形成的簇状钙化灶且临床不能触及肿块:BI-RADS(乳腺影像报告和数据系统)分级为Ⅲ-Ⅳ级且病灶钙化范嗣小于2 cm2的患者,在麻醉下行病灶区域性切除,术中离体标本依靠钼靶X线摄影再次定位,以大头针针尖标示簇状钙化中心位置,指导病理医生取材并活检.结果 65例离体标本共行69次铜靶X线摄影,65例病灶均能成功定位并准确获取病理标本,最终病理定性诊断.病理示乳腺癌21例(其中浸润性导管癌11例,早期浸润性导管癌6例,导管内原位癌4例),立即行相应手术治疗;导管增生性病变42例(普通型导管增生24例;平坦型上皮非典型增生9例;非典型导管增生6例,导管内乳头状瘤3例);纤维腺瘤2例.乳腺癌检出率为32.3%,诊断准确率100%.结论钼靶X线指导乳腺无肿块型簇状钙化术中病理标本取材,定位准确,诊断明确,能确定乳腺微小病变的性质,提高乳腺癌的诊断率.
목적 탐토목파X선대지도유선무종괴형족상개화리체표본술중병리취재적개치.방법 65례상규목파X선유선섭영현시무명현종괴형성적족상개화조차림상불능촉급종괴:BI-RADS(유선영상보고화수거계통)분급위Ⅲ-Ⅳ급차병조개화범사소우2 cm2적환자,재마취하행병조구역성절제,술중리체표본의고목파X선섭영재차정위,이대두침침첨표시족상개화중심위치,지도병리의생취재병활검.결과 65례리체표본공행69차동파X선섭영,65례병조균능성공정위병준학획취병리표본,최종병리정성진단.병리시유선암21례(기중침윤성도관암11례,조기침윤성도관암6례,도관내원위암4례),립즉행상응수술치료;도관증생성병변42례(보통형도관증생24례;평탄형상피비전형증생9례;비전형도관증생6례,도관내유두상류3례);섬유선류2례.유선암검출솔위32.3%,진단준학솔100%.결론 목파X선지도유선무종괴형족상개화술중병리표본취재,정위준학,진단명학,능학정유선미소병변적성질,제고유선암적진단솔.
Objective To explore the application value of mammography-guided breast drawing of calcificated nonpalpable samples.Methods 65 patients with calificated nonpalpable masses,graded Ⅲ-Ⅳ by BI-RADS,with a calcificated range,of less than 2 cm2,were included in this study.The lesions were resected under anesthesia;the isolated samples were re-positioned by mammography and then marked with apin-tip in'the center of clusters of calcification to guide pathologist to extract and perform biopsy.Results All of 65 lesions were successfully localized and accurately obtained.with 69 times of mammography.Pathological diagnosis showed malignant lesions in 21 samples(11 invasive ductal carcinoma,6 early ductal carcinoma,and 4 ductal carcinoma in situ),ductal hyperplasia in 42(22common type ductal hyperplasia,9 flat epithelial dysplasia,6 atypical ductal hyperplasia,and 3 intraductal papilloma),and fibroadenoma in 2.The detection rate for breast cancer was 32.3%and the diagnostic accuracy was 100%.Conclusions Mammography-guided breast drawing of calcificated nonpalpable samples can provide accurate localization and precise diagnosis,especially in the diagnosis of small breast lesions,and improve the diagnostic rate of breast cancer.