Grunwald Susanne, Heyer Hans, Paepke Stefan, Schwesinger Günther, Schimming Anette, Hahn Markus, Thomas Anke, Jacobs Volker R, Ohlinger Ralf
Department of Obstetrics and Gynecology, Ernst Moritz Arndt University, Greifswald, Germany.
Onkologie. 2007 May;30(5):243-8. doi: 10.1159/000100848. Epub 2007 Apr 24.
Ductoscopy is gaining increased importance in the diagnosis of nipple discharge of unclear origin and intraductal proliferation. For this reason we compared its diagnostic value and feasibility to standard diagnostic methods.
Ductoscopy was compared to mammography, galactography, sonography, magnetic resonance imaging (MRI), nipple smear, fine needle aspiration cytology (FNAC), and high-speed core biopsy; feasibility, sensitivity, and specificity were investigated for each method.
71 ductoscopies were evaluated, which were followed up by open biopsies. Here, 3 invasive and 8 ductal carcinomas in situ were found, as well as 3 atypical ductal hyperplasias, 44 papillomas/papillomatoses, and 13 benign findings. Feasibility of ductoscopy was in this series 100%. Duct sonography showed the highest sensitivity (67.3%), followed by MRI (65.2%), galactography (56.3%), ductoscopy (55.2%), and FNAC (51.9%). The highest specificity was shown by FNAC, core biopsy, and galactography (each 100.0%), followed by mammography (92.3%), nipple smear (77.8%), ductoscopy, and duct sonography (each 61.5%); the lowest specificity was displayed by MRI (25.0%).
The results confirm that ductoscopy can be performed within the same range of sensitivity and specificity as other techniques. In order to make conclusive statements about ductoscopy, especially in order to precisely define the indications for this method, a prospective multicenter study was initiated.
导管内镜检查在不明原因乳头溢液及导管内增生性病变的诊断中日益重要。因此，我们将其诊断价值和可行性与标准诊断方法进行了比较。
将导管内镜检查与乳腺X线摄影、乳管造影、超声检查、磁共振成像（MRI）、乳头涂片、细针穿刺细胞学检查（FNAC）和高速芯针活检进行比较；对每种方法的可行性、敏感性和特异性进行了研究。
评估了71例导管内镜检查病例，并随后进行了开放性活检。在此过程中，发现了3例浸润性癌和8例导管原位癌，以及3例非典型导管增生、44例乳头状瘤/乳头状瘤病和13例良性病变。本系列中导管内镜检查的可行性为100%。导管超声检查显示出最高的敏感性（67.3%），其次是MRI（65.2%）、乳管造影（56.3%）、导管内镜检查（55.2%）和FNAC（51.9%）。FNAC、芯针活检和乳管造影显示出最高的特异性（均为100.0%），其次是乳腺X线摄影（92.3%）、乳头涂片（77.8%）、导管内镜检查和导管超声检查（均为61.5%）；MRI显示出最低的特异性（25.0%）。
结果证实，导管内镜检查的敏感性和特异性与其他技术处于同一范围。为了对导管内镜检查做出确定性的陈述，特别是为了精确界定该方法的适应证，已启动了一项前瞻性多中心研究。
