Uematsu Takayoshi, Kasami Masako
Division of Breast Imaging, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka 411-8777, Japan.
Breast Cancer Res Treat. 2008 May;109(2):251-3. doi: 10.1007/s10549-007-9642-4. Epub 2007 Jul 7.
Previous studies demonstrated that core wash cytology by stereotactic needle biopsy was useful for the immediate diagnosis of breast lesions. The purpose of this study was to assess the accuracy of core wash cytology of breast lesions by ultrasonographically (US) guided core needle biopsy (CNB). US-guided 18-gauge CNB was performed in a series of 458 cases. Each CNB sample was washed in saline solution. Core wash cytology of the washed core material was performed on material obtained by saline solution lavage of the fragments using a cytocentrifuge. The cytological diagnoses were divided into five categories: benign, atypical/indeterminate, suspicious/probably malignant, malignant, and unsatisfactory, which then were compared with the CNB results. The cytological diagnoses of the 458 cases were as follows: 106 lesions (23.1%) were benign, 28 lesions (6.1%) were atypical/indeterminate, 42 lesions (9.2%) were suspicious/probably malignant, 88 lesions (19.2%) were malignant, and 194 lesions (42.4%) were unsatisfactory. The core wash cytology had a sensitivity of 89% (141 of 158), and a specificity of 72% (76 of 106). The CNB showed 143 of 194 unsatisfactory samples (74%) to be benign, three to be high-risk, and 48 (25%) to be malignant. Unsatisfactory samples were obtained from significantly more benign than malignant lesions. In conclusion, the high rate of insufficient samples for core wash cytology of breast lesions by US-guided CNB makes its use impractical in this setting. This technique is not useful for immediate diagnosis of breast lesions by US-guided CNB.
先前的研究表明，立体定向针吸活检的洗芯细胞学检查有助于乳腺病变的即时诊断。本研究的目的是评估超声（US）引导下的芯针活检（CNB）对乳腺病变洗芯细胞学检查的准确性。对458例患者进行了US引导下的18G CNB。每个CNB样本在盐溶液中冲洗。对通过盐溶液灌洗碎片获得的材料进行洗芯细胞学检查，使用细胞离心机对洗过的芯材料进行检查。细胞学诊断分为五类：良性、非典型/不确定、可疑/可能恶性、恶性和不满意，然后将其与CNB结果进行比较。458例患者的细胞学诊断如下：106个病变（23.1%）为良性，28个病变（6.1%）为非典型/不确定，42个病变（9.2%）为可疑/可能恶性，88个病变（19.2%）为恶性，194个病变（42.4%）为不满意。洗芯细胞学检查的敏感性为89%（158例中的141例），特异性为72%（106例中的76例）。CNB显示，194个不满意样本中有143个（74%）为良性，3个为高危，48个（25%）为恶性。不满意样本在良性病变中比在恶性病变中明显更多。总之，US引导下的CNB对乳腺病变进行洗芯细胞学检查时，样本不足的发生率很高，使其在这种情况下无法实际应用。该技术对US引导下的CNB即时诊断乳腺病变无用。
