摘要
目的探讨钼靶X线对指导乳腺无肿块型簇状钙化离体标本术中病理取材的价值。方法65例常规钼靶X线乳腺摄影显示无明显肿块形成的簇状钙化灶且临床不能触及肿堍BI—RADS（乳腺影像报告和数据系统）分级为Ⅲ～Ⅳ级且病灶钙化范围小于2cm^2的患者，在麻醉下行病灶区域性切除，术中离体标本依靠钼靶X线摄影再次定位，以大头针针尖标示簇状钙化中心位置，指导病理医生取材并活检。结果65例离体标本共行69次钼靶X线摄影，65例病灶均能成功定位并准确获取病理标本，最终病理定性诊断。病理示乳腺癌21例（其中浸润性导管癌11例，早期浸润性导管癌6例，导管内原位癌4例），立即行相应手术治疗；导管增生性病变42例（普通型导管增生24例；平坦型上皮非典型增生9例；非典型导管增生6例，导管内乳头状瘤3例）；纤维腺瘤2例。乳腺癌检出率为32．3％，诊断准确率100％。结论钼靶X线指导乳腺无肿块型簇状钙化术中病理标本取材，定位准确，诊断明确，能确定乳腺微小病变的性质，提高乳腺癌的诊断率。
Objective To explore the application value of mammography-guided breast drawing of calcificated nonpalpable samples. Methods 65 patients with calificated nonpalpable masses, graded Ⅲ-Ⅳ by BI-RADS, with a calcificated range of less than 2 cm^2 , were included in this study. The lesions were resected under anesthesia; the isolated samples were re-positioned by mammography and then marked with a pin-tip in＇the center of clusters of calcification to guide pathologist to extract and perform biopsy. Results All of 65 lesions were successfully localized and accurately obtained, with 69 times of mammography. Pathological diagnosis showed malignant lesions in 21 samples （ 11 invasive ductal carcinoma, 6 early ductal carcinoma, and 4 ductal carcinoma in situ ）, ductal hyperplasia in 42 （ 22 common type ductal hyperplasia, 9 flat epithelial dysplasia, 6 atypical ductal hyperplasia, and 3 intraductal papilloma ）, and fibroadenoma in 2. The detection rate for breast cancer was 32.3% and the diagnostic accuracy was 100%. Conclusions Mammography -guided breast drawing of calcificated nonpalpable samples can provide accurate localization and precise diagnosis, especially in the diagnosis of small breast lesions, and improve the diagnostic rate of breast cancer.
出处
《国际医药卫生导报》
2011年第9期1058-1060,共3页
International Medicine and Health Guidance News
关键词
钼靶X线摄影
定位
乳腺
钙化
病理
Mammograpy
Positioning
Breast
Calcification
Pathology
