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乳腺肿块细针穿刺细胞学诊断标准的研究:951例细胞学与组织学对比分析

[Study on diagnostic standards for fine needle aspiration cytological diagnosis of breast masses: a comparative analysis of cytology and histology of 951 cases].

作者信息

Yu Xiaomeng, Wang Weidong, Zhang Changhuai, Huang Shoufang

机构信息

Department of Pathology, Beijing Friendship Hospital, The Capital University of Medical Sciences, Beijing 100050, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2002 Feb;31(1):26-9.

Abstract

OBJECTIVE

To study the basic morphological factors and the reliability and limitations of the diagnostic standards of fine needle aspiration cytology (FNAC) of breast masses which drafted.

METHODS

A total of 4 309 fine needle aspiration biopsy cases of breast were performed and 951 cases of which were checked with their histological diagnosis.

RESULTS

Of the 413 aspiration smear studies, relatively identical morphological features were found on the smears of lesions of the same nature. The sensitivity of diagnosis of malignant tumor in 732 cases, the specificity of diagnosis of benign lesion in 219 cases and the overall accuracy of diagnosis were 97.3%, 97.7%, and 97.4% respectively. The false negative rate, potential false positive rate and the overall misdiagnosis rate were 2.7%, 2.3% and 2.6% respectively, no false positive diagnosis case was found.

CONCLUSIONS

(1) The differentiation and the arrangement pattern of the tubular epithelial cells and the amount of benign naked nuclear cells are the three essential factors in the analysis of morphological changes of FNAC of breast mass. (2) The examination of our diagnostic standards of FNAC of breast masses shows that the standards are very reliable but have certain limitations which need to be resolved by histopathological diagnosis.

摘要

目的

研究自行拟定的乳腺肿块细针穿刺细胞学检查(FNAC)诊断标准的基本形态学因素及其可靠性和局限性。

方法

共进行4309例乳腺细针穿刺活检,其中951例进行了组织学诊断对照。

结果

在413例穿刺涂片研究中,相同性质病变的涂片上发现了相对一致的形态学特征。732例恶性肿瘤诊断的敏感性、219例良性病变诊断的特异性及总体诊断准确率分别为97.3%、97.7%和97.4%。假阴性率、潜在假阳性率及总体误诊率分别为2.7%、2.3%和2.6%,未发现假阳性诊断病例。

结论

(1)腺管上皮细胞的分化程度、排列方式及良性裸核细胞数量是乳腺肿块FNAC形态学变化分析的三个关键因素。(2)对乳腺肿块FNAC诊断标准的检验表明,该标准非常可靠,但有一定局限性,需通过组织病理学诊断加以解决。

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