中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2010年
1期
37-39
,共3页
李太玉%孙晓%王永胜%赵月环%仲伟霞%周正波%李永清%穆殿斌
李太玉%孫曉%王永勝%趙月環%仲偉霞%週正波%李永清%穆殿斌
리태옥%손효%왕영성%조월배%중위하%주정파%리영청%목전빈
乳腺癌%真空辅助活检
乳腺癌%真空輔助活檢
유선암%진공보조활검
Breast Cancer%Vacuum-assisted Biopsy
目的 探讨超声引导真空辅助活检(VAB)对乳腺癌的诊断价值.方法 回顾性分析接受术前超声引导VAB的825例乳腺癌的临床资料.结果 817例VAB病理与术后病理诊断一致,8例组织学低估(0.96%).与术后肿瘤标本对比,36例乳腺癌VAB取材标本ER、HER-2检测的准确性、敏感性、特异性、阳性预测值和阴性预测值分别为91.4%、86.7%、95.0%、92.9%、90.5%,88.6%、87.5%、90.9%、95.5%和76.9%.12例超声提示良性病变且肿瘤<2cm的患者接受肿瘤VAB切除术,VAB病理示浸润性癌,均行进一步手术治疗,术后病理示3例活检残腔未见残留癌,9例残腔见癌成分及不典型增生.结论 VAB对乳腺癌患者术前提供明确病理诊断,为进一步手术、新辅助化疗提供诊断依据,同时VAB获得的肿瘤组织可行相关预后及预测指标检测.但VAB无法做到对"小乳腺癌"的完全切除,接受保乳手术的患者仍然需要接受进一步扩大切除,保证切缘阴性.
目的 探討超聲引導真空輔助活檢(VAB)對乳腺癌的診斷價值.方法 迴顧性分析接受術前超聲引導VAB的825例乳腺癌的臨床資料.結果 817例VAB病理與術後病理診斷一緻,8例組織學低估(0.96%).與術後腫瘤標本對比,36例乳腺癌VAB取材標本ER、HER-2檢測的準確性、敏感性、特異性、暘性預測值和陰性預測值分彆為91.4%、86.7%、95.0%、92.9%、90.5%,88.6%、87.5%、90.9%、95.5%和76.9%.12例超聲提示良性病變且腫瘤<2cm的患者接受腫瘤VAB切除術,VAB病理示浸潤性癌,均行進一步手術治療,術後病理示3例活檢殘腔未見殘留癌,9例殘腔見癌成分及不典型增生.結論 VAB對乳腺癌患者術前提供明確病理診斷,為進一步手術、新輔助化療提供診斷依據,同時VAB穫得的腫瘤組織可行相關預後及預測指標檢測.但VAB無法做到對"小乳腺癌"的完全切除,接受保乳手術的患者仍然需要接受進一步擴大切除,保證切緣陰性.
목적 탐토초성인도진공보조활검(VAB)대유선암적진단개치.방법 회고성분석접수술전초성인도VAB적825례유선암적림상자료.결과 817례VAB병리여술후병리진단일치,8례조직학저고(0.96%).여술후종류표본대비,36례유선암VAB취재표본ER、HER-2검측적준학성、민감성、특이성、양성예측치화음성예측치분별위91.4%、86.7%、95.0%、92.9%、90.5%,88.6%、87.5%、90.9%、95.5%화76.9%.12례초성제시량성병변차종류<2cm적환자접수종류VAB절제술,VAB병리시침윤성암,균행진일보수술치료,술후병리시3례활검잔강미견잔류암,9례잔강견암성분급불전형증생.결론 VAB대유선암환자술전제공명학병리진단,위진일보수술、신보조화료제공진단의거,동시VAB획득적종류조직가행상관예후급예측지표검측.단VAB무법주도대"소유선암"적완전절제,접수보유수술적환자잉연수요접수진일보확대절제,보증절연음성.
Objective To evaluate roles of ultrasound-guided vacuum-assisted biopsy (VAB) for the diagnosis of breast cancer. Methods A database containing 825 breast cancer patients who received VAB from Jan. 2004 to Sep. 2009 was retrospectively studied. Results Of the 825 patients, 817 patients had the same VAB pathology with the final pathology, while 8 were underestimated (0.96%). Compared to the final surgical specimen, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value for the ER expressions by the tissue taken by VAB were 91.4%, 86.7%, 95.0%, 92.9% and 90.5%, respectively, and 88.6%, 87.5%, 90.9%, 95.5% and 76.9%, respectively for HER-2 . 12 patients were considered of having benign tumors (not larger than 2 cm) by ultrasound, and they received VAB resections with the VAB pathology of invasive breast cancer. After a further surgery, 9 had carcinoma or atypical hyperplasia tissues in the residual cavity, while 3 not. Conclusions VAB was a safe, accurate, and minimally invasive method for the histological diagnosis of breast cancer patients before further surgery and neoadjuvant chemotherapy, and it could provide same prognosis and predictive information for the patients. However, VAB could not suitable for the resection of "small breast cancer" and those who received breast conserving therapy still need further resection.
