CAJ | 학술논문

目的：旨在探讨X线立体定位穿刺活检对不可触及乳腺疾病组织病理结果的准确性及其临床价值。方法81例X线发现乳腺异常而临床触诊阴性的患者，观察病变X线表现及病变发生的部位，后行X线立体三维定位穿刺活检。根据病理结果，统计活检取得的阳性率、病理类型及其所占的比例、获取的组织条数与病理阳性率的关系。对活检病理结果与最终病理结果(手术和复查)符合程度进行统计学分析。结果81例患者X线共发现84处病变，表现微小钙化61例、腺体增厚16例、腺体扭曲7例。病变位于外上象限47例。84处病变(81例患者)均操作成功，穿刺活检成功率为100%。阳性率为79.76%(67/84)，其中乳腺癌0.75%(6/84)、良性病变71.42%(60/84)、阴性率20%(17/84)。22例行手术治疗的病例中，活检病理结果6处乳腺癌与其手术后病理结果相符，58处良性病变中14例手术治疗，病理结果相一致。17处阴性者，有2处为术后病理为乳腺增生病伴囊肿，穿刺活检病理结果与最终手术病理结果作X2检验比较，两者无统计学意义(X2=3.2，p值=0.74＞0.05)。其余良性病变与阴性者，6个月以上复查， X线表现未见改变。结论 X线立体定位穿刺活检对临床触诊阴性的乳腺病变定位准确，活检阳性率高。为乳腺病变定性诊断，特别是临床表现不明确的乳腺癌早期检出有重要的价值。
목적：지재탐토X선입체정위천자활검대불가촉급유선질병조직병리결과적준학성급기림상개치。방법81례X선발현유선이상이림상촉진음성적환자，관찰병변X선표현급병변발생적부위，후행X선입체삼유정위천자활검。근거병리결과，통계활검취득적양성솔、병리류형급기소점적비례、획취적조직조수여병리양성솔적관계。대활검병리결과여최종병리결과(수술화복사)부합정도진행통계학분석。결과81례환자X선공발현84처병변，표현미소개화61례、선체증후16례、선체뉴곡7례。병변위우외상상한47례。84처병변(81례환자)균조작성공，천자활검성공솔위100%。양성솔위79.76%(67/84)，기중유선암0.75%(6/84)、량성병변71.42%(60/84)、음성솔20%(17/84)。22례행수술치료적병례중，활검병리결과6처유선암여기수술후병리결과상부，58처량성병변중14례수술치료，병리결과상일치。17처음성자，유2처위술후병리위유선증생병반낭종，천자활검병리결과여최종수술병리결과작X2검험비교，량자무통계학의의(X2=3.2，p치=0.74＞0.05)。기여량성병변여음성자，6개월이상복사， X선표현미견개변。결론 X선입체정위천자활검대림상촉진음성적유선병변정위준학，활검양성솔고。위유선병변정성진단，특별시림상표현불명학적유선암조기검출유중요적개치。
Objectvie To evaluate the histopathological accuracy and clinical value of three-dimensional localizing aspiration biopsy by X-guide in diagnosing unpalpated breast diseases. Methods Manifestations of breast X-ray displayed abnormal in 81 patients and palpating were negative. X-ray manifestations of breast diseases and the locations were observed then three-dimensional localizing puncture by X-guide were done. According to the histopathology, the succeeding, positive, pathological types were accounted. The relation of number of tissue piece captured with pathological positive rate were analysed. The pathological results of aspiration biopsy were collated with finally pathological results (surgery and countercheck). Results Eighty-four focuses were detected in 81 patients by X-ray including 61 micro-calcific focuses, 16 glandulose incrassation, 7 glandulose distorting. Fourty-seven focuses located in outer-up quadrants. Operations were succeeding in all patients,The succeeding rate of puncture was 100%. Positive rate of aspiration biopsy accounted for 79.76%(67/84) including breast carcinoma accounted for 0.75%(6/84), benign disease was 71.42%(60/81), negative rate was 20%(17/84).In 22 operated cases, aspiration biopsy pathological results in 6 breast carcinomas was according to pathological results of surgery. Surgerical operation were performed in 14 cases of 58 benign focuses that both pathological results were consistent. Surgerical operation were performed in 2 cases of 17 negative that pathological results were breast hyperplasia with cyst. X2 test were done between cases of histopathological types from aspiration biopsy and ones from operation that had not statistical significance (X2=3.2,p=0.74>0.05).X-rays were performed again in the rest patiens of benign focuses and negative by puncture after more 6 months which manifestations of X-rays had no changed. Conclusion Three-dimensional localizing aspiration biopsy by X-guide could correctly localized, positive rate was high and negative rate was low to breast diseases which palpating were negative. It was a valuable means for qualitation of breast disease, specially breast carcinaoma with unconspicuous symptom.