Kashiwagi Shinichiro, Onoda Naoyoshi, Asano Yuka, Noda Satoru, Kawajiri Hidemi, Takashima Tsutomu, Ohsawa Masahiko, Kitagawa Seiichi, Hirakawa Kosei
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585 Japan.
Springerplus. 2013 Aug 6;2:372. doi: 10.1186/2193-1801-2-372. eCollection 2013.
Recently, therapies targeting the biological characteristics of individual cancers according to markers indicating underlying molecular biological mechanisms have become available. Core needle biopsy (CNB) is widely used, not only to diagnose, but also to determine therapeutic strategies, in patients with breast cancer. Although the diagnostic accuracy of CNB is acceptably high, false-negative results have occasionally been encountered.
The results of adjunctive imprint cytology (AIC) coinciding with CNB in 2,820 patients suspected to have breast cancer were retrospectively reviewed. The feasibility and clinical usefulness of AIC-assisted diagnosis were analyzed.
Fourteen-hundred and sixty-four cases were diagnosed as not malignant using CNB alone. Forty-seven of 1464 cases were suspected to be malignant on a cytological review of AIC, and 42 were confirmed to be breast cancer on additional biopsies. The combination of CNB and AIC achieved a sensitivity of 100% (1398/1398) and a specificity of 99.6% (1417/1422). Small lesions and large noninvasive- or scirrhous-type carcinomas were the common features of the CNB-negative/AIC-positive cases.
Adjunctive imprint cytodiagnosis is a simple and easy procedure that assists the pathological diagnosis of breast cancer using CNB and therefore serves as a possible novel standard application.
近年来，根据指示潜在分子生物学机制的标志物针对个体癌症的生物学特征进行治疗已成为可能。在乳腺癌患者中，粗针穿刺活检（CNB）不仅广泛用于诊断，还用于确定治疗策略。尽管CNB的诊断准确性较高，但偶尔也会出现假阴性结果。
回顾性分析2820例疑似乳腺癌患者中与CNB相符的辅助印片细胞学检查（AIC）结果。分析AIC辅助诊断的可行性和临床实用性。
仅使用CNB诊断为非恶性的病例有1464例。在对AIC进行细胞学复查时，1464例中有47例疑似恶性，其中42例经再次活检确诊为乳腺癌。CNB与AIC联合使用时，敏感性为100%（1398/1398），特异性为99.6%（1417/1422）。CNB阴性/AIC阳性病例的常见特征为小病灶以及大的非浸润性或硬癌型癌。
辅助印片细胞诊断是一种简单易行的方法，可辅助CNB对乳腺癌进行病理诊断，因此可作为一种可能的新型标准应用。
