| 刘慧敏,曹小丽,刘瑞华.超声引导下穿刺活检对乳腺癌前病变的诊断价值[J].中国医学影像技术,2017,33(5):670~674 |
| 超声引导下穿刺活检对乳腺癌前病变的诊断价值 |
| Value of ultrasound-guided core needle biopsy in diagnosing precancerous lesions of breast cancer |
| 投稿时间：2016-09-07 修订日期：2017-02-01 |
| DOI：10.13929/j.1003-3289.201609030 |
| 中文关键词: 超声检查 活组织检查 乳腺肿瘤 |
| 英文关键词:Ultrasonography Biopsy Breast neoplasms |
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| 中文摘要: |
| 目的 探讨超声引导下穿刺活检诊断乳腺癌前病变的准确性及提示病变可能被低估的超声表现。方法 收集经超声引导下穿刺活检的乳腺肿物患者605例，记录肿物的超声表现，将穿刺病理结果与术后病理或随访结果进行对比。结果 除3例患者因组织过少未获得穿刺病理诊断外，602例患者的穿刺病理与术后病理或随访结果对比，符合率为97.84%（589/602），两者间一致性较好（Kappa=0.96，P=0.01）。穿刺活检结果为癌前病变者与术后病理或随访结果对比符合组32例，低估组10例，低估率为23.81%（10/42）。符合组和低估组癌前病变的钙化、后方回声衰减、血流、可疑淋巴结在两组间差异有统计学意义（P均<0.05）。结论 超声引导下穿刺活检对诊断乳腺肿物的准确率较高，但对癌前病变存在一定低估，尤其对于超声表现有恶性特征的癌前病变应考虑低估的可能。 |
| 英文摘要: |
| Objective To investigate the value of ultrasound-guided core needle biopsy in diagnosing precancerous lesions of breast cancer. Methods Totally 605 cases were enrolled. Ultrasound characteristics were recorded. The pathological diagnosis on ultrasound-guided core needle biopsy was compared with the findings of the excisional biopsy and follow-up results. Results In all of the 605 cases, 3 cases were failed on ultrasound-guided core needle biopsy because of less biopsied tissue. The accuracy of ultrasound-guided core needle biopsy was 97.84% (589/602), the Kappa value was 0.96 (P=0.01). In biopsy, 42 cases were precancerous lesions of breast cancer, and divided into according group (n=32) and upgrading group (n=10) according to surgical pathology or follow-up results. The rate of underestimation was 23.81% (10/42). Compared to according group, microcalcification, acoustic attenuation, rich vascular and suspicious axillary lymph nodes had statistical difference in upgrading group (all P<0.05). Conclusion Ultrasound-guided core needle biopsy is accurate in the diagnosis of breast neoplasm, however, ultrasound-guided core needle biopsy diagnosis of precancerous lesions are partly underestimated. To some degree, ultrasound characteristics of precancerous lesions of breast cancer could predict the underestimation. |
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