CAJ | 학술논문

目的：对比乳管镜与乳管造影在诊断未扪及肿块的乳头溢液性疾病中的效果。方法对42例未扪及肿块的乳头溢液患者分别行乳管镜及乳管造影检查，以手术后病理诊断为“金标准”，对比乳管镜和乳管造影对乳头溢液性疾病诊断效果。结果乳管镜与乳管造影均能够获得清晰图像。术后病理诊断为占位性病变38例，包括乳管内乳头状瘤27例，乳管内乳头状瘤病9例，导管内癌2例；非占位性病变4例，为乳腺导管扩张性疾病。乳管镜对未扪及肿块的乳头溢液性疾病的诊断符合率为92．86％，灵敏度为94．59％，特异度为80．00％，阴性预测值为66．67％，阳性预测值为97．22％，均明显高于乳管造影的80．95％、88．24％、50．00％、50．00％、88．24％。结论乳管镜可作为未扪及肿块的乳头溢液患者的首选诊断方法，乳管镜结合乳腺导管造影检查可减少误诊及漏诊。
목적：대비유관경여유관조영재진단미문급종괴적유두일액성질병중적효과。방법대42례미문급종괴적유두일액환자분별행유관경급유관조영검사，이수술후병리진단위“금표준”，대비유관경화유관조영대유두일액성질병진단효과。결과유관경여유관조영균능구획득청석도상。술후병리진단위점위성병변38례，포괄유관내유두상류27례，유관내유두상류병9례，도관내암2례；비점위성병변4례，위유선도관확장성질병。유관경대미문급종괴적유두일액성질병적진단부합솔위92．86％，령민도위94．59％，특이도위80．00％，음성예측치위66．67％，양성예측치위97．22％，균명현고우유관조영적80．95％、88．24％、50．00％、50．00％、88．24％。결론유관경가작위미문급종괴적유두일액환자적수선진단방법，유관경결합유선도관조영검사가감소오진급루진。
Objective To compare the effects of fiberoptic ductoscopy versus galactography applied to the diagnosis of nipple discharge without palpable mass.Methods Forty-two nipple discharge patients without palpable mass accepted fiberoptic ductoscopy and galactography, respectively.Taking the postoperative pathological results as the golden standard,the effects of fiberoptic ductoscopy and galactography applied to the diagnosis of nipple discharge were compared.Results Fiberoptic ductoscopy and galactography were successfully imaged.The postoperative pathological result showed that there were 38 cases of space-occupying lesion which included 27 cases of intraductal papilloma,9 cases of intraductal papillomatosis and 2 cases of ductal carcinoma in situ,and 4 cases of non-space-occupying lesion which were mammary ductal ectasia.The diagnostic coincidence rate of fiberoptic ductoscopy for nipple discharge without palpable mass was 92.86%.The sensitivity, specificity,negative predictive value and positive predictive value of fiberoptic ductoscopy were significantly higher than those of galactography (94.59% vs.80.95%,80.00% vs.88.24%,66.67% vs.50.00% and 97.22% vs.88.24%,respectively,P <0.05).Conclusion Fiberoptic ductoscopy could be the first choice for the diagnosis of nipple discharge without palpable mass.Fiberoptic ductoscopy combined with galactography might contribute to reducing misdiagnosis and missed diagnosis.