摘要
目的探讨术中标本摄片系统联合X线立体定位真空辅助活检(SVAB)在乳腺钙化诊断中的应用价值,为临床诊断提供参考依据。方法选取2016年1月-2017年5月在该院行X线立体定位乳腺钙化真空辅助活检术的186例患者为研究对象,回顾性分析活检时间、术中标本摄片次数、活检病理结果、后续手术病理结果及组织学低估情况。结果活检耗时平均40.38分,28.5%的患者需重复活检取样。活检病理乳腺导管不典型增生(ADH)22例(占11.8%),导管内癌(DCIS)19例(占10.2%),小叶原位癌(LCIS)1例(占1.2%),浸润性导管癌(IDC)3例(占1.6%),其他良性病理共141例。诊断ADH组织学低估率为12.5%(2/16),诊断DCIS组织学低估率为26.3%(5/19)。45例(24.2%)活检病理为ADH、DCIS、LCIS及IDC的患者中,15例将钙化标本与不含钙化标本单独送病理检查,46.7%(7/15)病理不一致。结论术中应用标本摄片系统可以术中快速确认是否切取目标钙化,缩短活检耗时,将钙化标本单独送检利于病理诊断,联合SVAB对诊断乳腺微钙化具有较高的临床价值。
Objective To explore the application value of intraoperative digital specimen mammography（ IDSM） combined with stereotactic vacuum-assisted biopsy（ SVAB） in diagnosis of breast calcification, provide a reference basis for clinical diagnosis.Methods From January 2016 to May 2017,186 patients undergoing IDSM combined with SVAB in Shenzhen Hospital were selected as research object. The biopsy time,the times of IDSM,the pathological results of biopsy and subsequent surgery,histological underestimation were analyzed retrospectively. Results The mean time of biopsy was 40. 38 minutes. Repeated sampling during biopsy was performed among28. 5% of the patients. Pathological examination of biopsy found 22 patients（ 11. 8%） with atypical ductal hyperplasia（ ADH）,19 patients（ 10. 2%） with ductal carcinoma in situ（ DCIS）,1 patient（ 1. 2%） with lobular carcinoma in situ（ LCIS）,3 patients（ 1. 6%） with invasive ductal carcinoma（ IDC）,and 141 patients with other benign diseases. The histological underestimation rates of diagnosis of ADH and DCIS were 12. 5%（ 2/16） and 26. 3%（ 5/19）,respectively. Among 45 patients（ 24. 2%） with ADH,DCIS,LCIS,and IDC diagnosed by pathological examination after biopsy,15 patients underwent pathological examination of calcified specimens and uncalcified specimens,inconsistent pathological results were found in 46. 7%（ 7/15） of the patients. Conclusion IDSM can rapidly confirm calcification of the specimens or not,shorten biopsy time,separate pathological examination of calcified specimens,and contributes to diagnosis,combining with SVAB has high clinical value of diagnosis of breast microcalcification.
作者
郑爱秋
魏建南
石剑
杨勇
杨卫林
饶美凤
ZHENG Ai-Qiu;WEI Jian-Nan;SHI Jian(Department of Breast Surgery, Shenzhen Hospital, the University of Hong Kong , Shenzhen , Guangdong 518048, China)
出处
《中国妇幼保健》
CAS
2018年第12期2809-2812,共4页
Maternal and Child Health Care of China
基金
广东省医学科学技术研究基金项目(A2018194)
关键词
乳腺钙化
术中标本摄片
X线立体定位真空辅助活检术
Breast calcification
Intraoperative digital specimen mammography
Stereotactic vacuum-assisted biopsy
