Poellinger Alexander, Diekmann Susanne, Dietz Ekkehart, Bick Ulrich, Diekmann Felix
Department of Radiology, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
Eur Radiol. 2008 May;18(5):925-30. doi: 10.1007/s00330-007-0846-0. Epub 2008 Jan 8.
The purpose was to investigate in patients with histologically proven DCIS to what extent there is agreement between radiographically proven microcalcifications of specimens obtained by vacuum-assisted biopsy and the histologic diagnosis of microcalcifications and DCIS, and second, to assess the accuracy of biopsy in relation to the number of specimens obtained in patients with high-grade and low-grade DCIS. Four hundred twenty specimens from 35 patients who were diagnosed with DCIS were examined radiographically and histologically for the presence of microcalcifications. The results were analyzed using the McNemar-test. In addition, the average numbers of biopsy specimens necessary for diagnosing low-grade DCIS and high-grade DCIS were compared using the t-test. Specimen radiography had a PPV of 0.50 and a NPV of 0.85 for the demonstration of DCIS. Differences in localization between radiographically proven microcalcifications and DCIS were statistically significant (p<0.01). The difference between the mean numbers of specimens required per patient for correctly diagnosing high-grade or low-grade DCIS was statistically significant (p<0.01). Specimen radiography is very limited in identifying those specimens that are crucial for diagnosing DCIS. The rate of underestimation is expected to be higher for low-grade than for high-grade DCIS. The findings suggest that all samples obtained by vacuum-assisted breast biopsy should be histologically examined.
目的是在组织学确诊为导管原位癌（DCIS）的患者中，研究经影像学证实的真空辅助活检获取标本的微钙化与微钙化及DCIS的组织学诊断之间的一致程度；其次，评估活检在高级别和低级别DCIS患者中与获取标本数量相关的准确性。对35例诊断为DCIS的患者的420份标本进行了影像学和组织学检查，以确定是否存在微钙化。结果采用McNemar检验进行分析。此外，使用t检验比较诊断低级别DCIS和高级别DCIS所需活检标本的平均数量。标本放射成像对于DCIS的显示，阳性预测值为0.50，阴性预测值为0.85。经影像学证实的微钙化与DCIS在定位上的差异具有统计学意义（p<0.01）。正确诊断高级别或低级别DCIS每位患者所需标本平均数量之间的差异具有统计学意义（p<0.01）。标本放射成像在识别对诊断DCIS至关重要的标本方面非常有限。低级别DCIS的低估率预计高于高级别DCIS。研究结果表明，通过真空辅助乳腺活检获得的所有样本均应进行组织学检查。
