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在有乳头溢液病理改变的女性中,经乳管镜钢丝标记后行选择性微小乳管切除术。

Selective microdochectomy after ductoscopic wire marking in women with pathological nipple discharge.

作者信息

Hahn M, Fehm T, Solomayer E F, Siegmann K C, Hengstmann A S, Wallwiener D, Ohlinger R

机构信息

Department of Obstetrics and Gynaecology, University Hospital Tuebingen, Tuebingen, Germany.

出版信息

BMC Cancer. 2009 May 17;9:151. doi: 10.1186/1471-2407-9-151.

Abstract

BACKGROUND

To investigate the diagnostic reliability of selective microdochectomy after direct ductoscopic wire marking of suspect lesions in patients with pathological nipple discharge.

METHODS

Selective microdochectomy due to pathological discharge was performed in 33 patients with mean age of 51.7 years. Ductoscopes of 0.9 and 1.1 mm in diameter with a channel for wire marking were used. Only patients without sonographic or mammographic correlation for the discharge were included. The pathologic mammary duct was wire marked and extirpated under direct visual guidance via the ductoscope. The histological results were compared with cytology, galactography and ductoscopy.

RESULTS

In 24 out of 33 cases (72%) an intraductal, epithelial proliferation was found histologically. The following sensitivities for intraductal, epithelial proliferations could be determined: cytology 4%, galactography 74%, and ductoscopy 78%.

CONCLUSION

The method allows selective microdochectomy of the pathological duct and the intraductal proliferation under visual guidance. The resection volume can be reduced in contrast to the unselective ductectomy after injection of methylene blue.

摘要

背景

探讨在病理性乳头溢液患者中,对可疑病变进行直接导管内镜导丝标记后选择性乳腺导管微切除术的诊断可靠性。

方法

对33例平均年龄51.7岁、因病理性溢液而行选择性乳腺导管微切除术的患者进行研究。使用直径为0.9和1.1mm且带有导丝标记通道的导管内镜。仅纳入那些溢液与超声或乳腺X线摄影检查结果无相关性的患者。在直视下通过导管内镜对病理性乳腺导管进行导丝标记并切除。将组织学结果与细胞学、乳腺导管造影及导管内镜检查结果进行比较。

结果

33例中有24例(72%)组织学检查发现导管内上皮增生。对于导管内上皮增生,可确定以下敏感性:细胞学检查为4%,乳腺导管造影为74%,导管内镜检查为78%。

结论

该方法可在直视下对病理性导管及导管内增生进行选择性乳腺导管微切除术。与注射亚甲蓝后进行的非选择性乳腺导管切除术相比,可以减少切除范围。

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