CAJ | 학술논문

目的评价乳管镜检查中乳管内灌洗细胞学检查对乳头溢液的诊断价值。方法选择2010年6-9月79例乳管镜诊断导管内隆起性病变，对病变导管进行手术、病理组织检查。并且分别在乳管镜检查前取乳头溢液涂片和乳管镜检查中对溢液导管用盐水灌洗，取灌洗液涂片行脱落细胞学检查的临床资料进行对比分析。结果79例乳管镜诊断导管内隆起性病变经手术病理组织检查证实：导管增生性病变66例（导管上皮增生25例，非典型增生1例，导管内乳头状瘤40例），乳腺导管扩张炎症13例。脱落细胞学检查结果：常规细胞学检查导管内增生性病变主要表现为吞噬细胞和淋巴细胞（28％～40％）。灌洗液细胞学检查结果：导管内乳头状瘤主要表现为导管上皮细胞（50％）和增生的导管上皮细胞（30％）。导管普通型增生为导管上皮细胞（48％），非典型增生为增生性上皮细胞，2种细胞学检查导管内增生性病变差异有统计学意义（ P ＜0．05）。导管扩张、炎性常规细胞学检查为淋巴细胞（46．15％）和吞噬细胞（30．77％），灌洗液细胞学检查为吞噬细胞（38．46％）和炎性细胞（23．08％），2种细胞学检查结果差异无统计学意义（ P ＞0．05）。常规细胞学的阳性预测值为88．89％，阴性预测值为18．03％，灵敏度为24．24％，特异度为84．62％；灌洗细胞学阳性预测值为94．83％，阴性预测值为47．62％，灵敏度为83．33％，特异度为76．92％，2种方法差异有统计学意义（ P ＜0．05）。结论常规细胞学和灌洗细胞学涂片、脱落细胞学检查与病理组织学检查结果相比，灌洗液细胞学诊断符合率明显高于常规细胞学。
목적평개유관경검사중유관내관세세포학검사대유두일액적진단개치。방법선택2010년6-9월79례유관경진단도관내륭기성병변，대병변도관진행수술、병리조직검사。병차분별재유관경검사전취유두일액도편화유관경검사중대일액도관용염수관세，취관세액도편행탈락세포학검사적림상자료진행대비분석。결과79례유관경진단도관내륭기성병변경수술병리조직검사증실：도관증생성병변66례（도관상피증생25례，비전형증생1례，도관내유두상류40례），유선도관확장염증13례。탈락세포학검사결과：상규세포학검사도관내증생성병변주요표현위탄서세포화림파세포（28％～40％）。관세액세포학검사결과：도관내유두상류주요표현위도관상피세포（50％）화증생적도관상피세포（30％）。도관보통형증생위도관상피세포（48％），비전형증생위증생성상피세포，2충세포학검사도관내증생성병변차이유통계학의의（ P ＜0．05）。도관확장、염성상규세포학검사위림파세포（46．15％）화탄서세포（30．77％），관세액세포학검사위탄서세포（38．46％）화염성세포（23．08％），2충세포학검사결과차이무통계학의의（ P ＞0．05）。상규세포학적양성예측치위88．89％，음성예측치위18．03％，령민도위24．24％，특이도위84．62％；관세세포학양성예측치위94．83％，음성예측치위47．62％，령민도위83．33％，특이도위76．92％，2충방법차이유통계학의의（ P ＜0．05）。결론상규세포학화관세세포학도편、탈락세포학검사여병리조직학검사결과상비，관세액세포학진단부합솔명현고우상규세포학。
Objective To evaluate the diagnostic value of lavage cytology to nipple discharge in laticifers en-doscopy .Methods 79 patients were diagnosed with introductal apophysis lesions by laticifers endoscopy from Jun to Sep 2010 and the diseased tubes underwent surgical treatment and postoperative pathological examination .Nipple discharge was collected ,and then exfoliocytology examination was conducted before laticifers endoscopy examination .And the diseased tubes were lavaged with natural soil water ,then lavage was collected and exfoliocytology examination was also conducted respectively .Finally ,the two cytological examination results were compared and analyzed .Results Under the postoperative pathological examina-tion ,66 cases of intraductal proliferative lesion were confirmed ,including 25 cases of ductal epithelial hy-Objective To evaluate the diagnostic value of lavage cytology to nipple discharge in laticifers en-doscopy .Methods 79 patients were diagnosed with introductal apophysis lesions by laticifers endoscopy from Jun to Sep 2010 and the diseased tubes underwent surgical treatment and postoperative pathological examination .Nipple discharge was collected ,and then exfoliocytology examination was conducted before laticifers endoscopy examination .And the diseased tubes were lavaged with natural soil water ,then lavage was collected and exfoliocytology examination was also conducted respectively .Finally ,the two cytological examination results were compared and analyzed .Results Under the postoperative pathological examina-tion ,66 cases of intraductal proliferative lesion were confirmed ,including 25 cases of ductal epithelial hy-perplasia ,1 case of atypical hyperplasia ,40 cases of papillomatosis ,and 13 cases of laticifers expansion and inflammation were detected .The results of exfoliocytology examination were demonstrated as fol-lowed :The main distribution of cells with intraductal proliferative lesions were phagocytic cells and lym-phocyte (28% ~40% ) in conventional cytology .Dutal epithelial hyperplasia (50% ) and proliferative duc-tal epithlial cells (30% ) were the main cells with papillomatosis in lavage cytology .Ductal epithelial hy-perplasia (48% ) was the main cell with intraductal typical hyperplasia and the proliferative ductal epithelial cell was the main cell with intraductal atypical hyperplasia .There were statistically significant differences between conventional cytology and lavagy cytology with the intraductal proliferative lesions (P <0 .05) . As to the laticifers expansion and inflammation ,the majority cells were lymphocyte (46 .15% ) and phago-cyte (30 .77% ) in conventional cytology and those were phagocyte (38 .46% ) and inflammation cell (23 .08% ) in lavage cytology .And there were not significant differences between the two examinations (P>0 .05) .In the conventional cytology ,the positive predictive value was 88 .89% ,the negative value 18 .03% ,sensitiv-ity 24 .24% ,and specficity 84 .60% .In the lavage cytology ,that is 94 .83% ,47 .62% ,83 .33% ,76 .92%respectively .There were significant differences between the examinations (P <0 .05) .Conclusion Diag-nostic accuracy of the lavage cytology was significantly higher than the conventional cytology .