CAJ | 학술논문

目的：总结无乳头溢液的乳腺导管内乳头状瘤（ intraductal papilloma ， IP）的临床特点、诊断及手术方式。方法回顾分析佛山市妇幼保健院2011年2月至2013年10月期间收治的84例（130个病灶）无乳头溢液症状的IP患者的临床资料。结果84例共130个病灶，年龄段主要分布于30～50岁，病灶长径≤10 mm 113个（86.92％），病灶位置距离乳头≤20 mm 84个（64.42％）；病理诊断IP合并腺病57个，IP合并纤维囊性腺病43个，IP合并纤维腺瘤48个，IP伴导管上皮增生14个，IP伴导管上皮非典型增生2个。随访3～36个月，复发5例，其中4例为IP，1例为导管原位癌。结论无乳头溢液的IP多无典型临床症状，超声检查可有不典型阳性发现，术前诊断符合率低，可积极手术活检。多发性及伴导管上皮不典型增生IP患者术后有一定复发率，应密切随访。
목적：총결무유두일액적유선도관내유두상류（ intraductal papilloma ， IP）적림상특점、진단급수술방식。방법회고분석불산시부유보건원2011년2월지2013년10월기간수치적84례（130개병조）무유두일액증상적IP환자적림상자료。결과84례공130개병조，년령단주요분포우30～50세，병조장경≤10 mm 113개（86.92％），병조위치거리유두≤20 mm 84개（64.42％）；병리진단IP합병선병57개，IP합병섬유낭성선병43개，IP합병섬유선류48개，IP반도관상피증생14개，IP반도관상피비전형증생2개。수방3～36개월，복발5례，기중4례위IP，1례위도관원위암。결론무유두일액적IP다무전형림상증상，초성검사가유불전형양성발현，술전진단부합솔저，가적겁수술활검。다발성급반도관상피불전형증생IP환자술후유일정복발솔，응밀절수방。
Objective To summarize the clinical characteristics , diagnosis and surgical method of intra-ductal papilloma(IP)of breast without nipple discharge .Methods The clinical data of 84 IP patients(130 le-sions)without nipple discharge admitted from Feb .2011 to Oct.2013 were analyzed retrospectively .Results The age of the 84 patients were mainly ranging from 30 to 50 years old.113(86.92%)lesions were≤10 mm in size, 84(64.42%)lesions had a distance≤20 mm to nipple, 57 accompanied by adenosis , 43 accompanied by fibro-cystic adenosis , 48 accompanied by fibroadenoma , 14 with ductal hyperplasia , and 2 with atypical ductal hyper-plasia.After a follow-up of 3 to 36 months, 5 cases had recurrence , including 4 cases of IP and 1 case of ductal carcinoma in situ.Conclusions IP without nipple discharge has no typical clinical symptoms .Ultrasound exam-ination may have positive findings , but not typical .Preoperative diagnosis is difficult and surgical biopsy is rec-ommended.Multiple and atypical ductal hyperplasia has possibility of recurrence , so follow-up is necessary.