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乳腺导管内镜检查在乳腺肿瘤诊断中的意义。

The significance of ductoscopy of mammary ducts in the diagnostics of breast neoplasms.

作者信息

Zielinski Jacek, Jaworski Radoslaw, Irga-Jaworska Ninela, Haponiuk Ireneusz, Jaskiewicz Janusz

机构信息

Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland.

Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Pomeranian Centre of Traumatology, Gdansk, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2015 Apr;10(1):79-86. doi: 10.5114/wiitm.2014.46823. Epub 2014 Dec 3.

Abstract

INTRODUCTION

Ductoscopy is a low invasive method enabling the diagnostics of intraductal proliferative lesions in breasts. Fiberoptic ductoscopy (FDS) is important in the diagnosis of patients with pathological nipple discharge. There are attempts to apply FDS in patients with breast cancer without the presence of nipple discharge.

AIM

To assess fiberoptic ductoscopy in the diagnostics of breast neoplasms.

MATERIAL AND METHODS

The material was composed of a group of 164 patients treated for intraductal proliferative lesions in breasts. In the analyzed group of patients, FDS was conducted in 128 patients with pathological nipple discharge and 36 patients with the presence of breast cancer. The analyzed period was divided into three sub-periods. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDS examination verified by post-operative histopathological examination were analyzed. The safety of the method was also assessed, taking into consideration the complications.

RESULTS

An increasing number of successful ductoscopies together with the number of performed FDS examinations was noted. There were statistically significant differences in the percentage of successful cannulations in relation to the number of performed FDS examinations in the three subsequent stages of the project (p = 0.011). The duration of FDS examination in the third period was reduced in comparison with the first and second period (p < 0.001). Sensitivity of fiberoptic ductoscopy is 68.1%, specificity 77.3% and PPV 90.4%, but NPV is 44.1%.

CONCLUSIONS

The introduction of fiberoptic ductoscopy in our clinic has contributed to the widening of the diagnostic possibilities of small intraductal lesions of the mammary gland.

摘要

引言

导管镜检查是一种低侵入性方法,可用于诊断乳腺导管内增生性病变。纤维乳管镜检查(FDS)在诊断病理性乳头溢液患者中具有重要意义。目前也尝试将FDS应用于无乳头溢液的乳腺癌患者。

目的

评估纤维乳管镜检查在乳腺肿瘤诊断中的作用。

材料与方法

研究材料为一组164例接受乳腺导管内增生性病变治疗的患者。在分析的患者组中,对128例病理性乳头溢液患者和36例乳腺癌患者进行了FDS检查。分析期分为三个子阶段。分析了经术后组织病理学检查验证的FDS检查的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)。还考虑并发症评估了该方法的安全性。

结果

注意到成功进行导管镜检查的数量以及所进行的FDS检查数量均有所增加。在项目的三个后续阶段,成功插管的百分比与所进行的FDS检查数量之间存在统计学显著差异(p = 0.011)。与第一和第二阶段相比,第三阶段FDS检查的持续时间缩短(p < 0.001)。纤维乳管镜检查的敏感性为68.1%,特异性为77.3%,PPV为90.4%,但NPV为44.1%。

结论

在我们诊所引入纤维乳管镜检查有助于扩大乳腺小导管内病变的诊断可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/073d/4415260/65bfe94d36e2/WIITM-10-23975-g001.jpg

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