CAJ | 학술논문

目的评价核心针活检(core needle biopsy,CNB)诊断乳腺病变的准确率和浸润性乳腺癌化疗前、后雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和Her2蛋白免疫组织化学(immunohistochemistry,IHC)检测结果的一致性.方法回顾性分析本院2005年6月至2008年4月间进行的516例CNB结果.结果本组所有资料均由两位病理医生独立进行病理学诊断.共诊断乳腺恶件肿瘤、原位癌和叶状肿瘤484例,灵敏度为96.7%.经手术活检证实的假阴性为16例(3.3%).CNB诊断准确率不受病灶最大径影响(P=0.423).接受化疗前、后IHC检测的乳腺癌ER、PR和Her2一致率分别为90.3%、76.8%和82.5%.结论 CNB是准确、有效的检查方法.受乳腺癌的组织异质性和治疗的双苇影响,化疗前后的ER、PR和Her2检测的一致性尚难获得满意结果.
목적 평개핵심침활검(core needle biopsy,CNB)진단유선병변적준학솔화침윤성유선암화료전、후자격소수체(estrogen receptor,ER)、잉격소수체(progesterone receptor,PR)화Her2단백면역조직화학(immunohistochemistry,IHC)검측결과적일치성.방법 회고성분석본원2005년6월지2008년4월간진행적516례CNB결과.결과 본조소유자료균유량위병리의생독립진행병이학진단.공진단유선악건종류、원위암화협상종류484례,령민도위96.7%.경수술활검증실적가음성위16례(3.3%).CNB진단준학솔불수병조최대경영향(P=0.423).접수화료전、후IHC검측적유선암ER、PR화Her2일치솔분별위90.3%、76.8%화82.5%.결론 CNB시준학、유효적검사방법.수유선암적조직이질성화치료적쌍위영향,화료전후적ER、PR화Her2검측적일치성상난획득만의결과.
Objective To evaluate the accuracy of core needle biopsy (CNB) in diagnosing breast masses and its coherence with immunohistochemical (IHC) examination results of estrogen receptor (ER), progesterone receptor (PR) and Her2 protein between pre-and post-chemotherapy in invasive breast cancer. Methods The results of 516 CNB cases from June, 2005 to April, 2008 were analyzed retrospectively. The pathological examination was performed by two pathologists independently. Results 484 cases of malignant tumor, carcinoma in situ and phyllodes tumor were found in this group with the sensitivity of 96.7%. Sixteen cases of false negative (3. 3% ) were demonstrated by surgical biopsy. The accurate rate of CNB was not influenced by the maximum diameter of masses ( P = O. 423 ). The agreement rate of IHC results of ER, PgR and Her2 between pre- and post-chemotherapy were 90. 3%, 76. 8% and 82.5%, respectively. Conclusion CNB is a useful diagnostic method with a satisfactory accuracy in any size of breast masses. Given the histological heterogeneity of invasive breast cancer and the influence of ehemotherapy, the coherence of prechemotherapy IHC for ER, PgR and Her2 is not optimal with that of post-chemotherapy.