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细针穿刺抽吸活检术(FNAC)与组织病理学在乳腺肿块诊断中的对比研究

A Comparative Study between FNAC and Histopathology in Diagnosis of Breast Lump.

作者信息

Islam A, Khondker N S, Rahman S, Reza E, Mahamud M M, Shaon S A, Mariam L, Pathan F H

机构信息

Dr Afroza Islam, Residential Surgeon, Department of Surgery, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh.

出版信息

Mymensingh Med J. 2015 Jul;24(3):486-91.

Abstract

Worldwide a large number of patients have been suffering from breast lump and this trend is gradually increasing. It is difficult to determine whether a lump is benign or malignant from clinical assessment. Thus the need for microscopic tissue analysis arises. This study was designed to determine the value of fine needle aspiration cytology in the diagnosis of breast lumps and to compare the result of FNAC with histopathological diagnosis to assess its accuracy. A prospective study in the period of January 2009 to December 2010 was done. One hundred and ten (110) patients who came to the Department of Surgery in Mymensingh Medical College Hospital, Bangladesh in two years for their palpable breast masses were chosen for the study. There were 70(63.63%) benign, 33(30.00%) malignant and 07(6.36%) suspicious smears in FNAC. Inadequate samples were repeated. The number of repeats increased the diagnostic accuracy of aspirates which is statistically significant when compared with histopathology. In histopathology Invasive ductal carcinoma was the most commonly reported lesion with maximum incidence in the 4th, 5th, and 6th decades followed by invasive lobular carcinoma and other malignant lesions. FNAC serves as a rapid, economical and reliable tool for the diagnosis of palpable breast lesions and its reliability is influenced by the skillness of the aspirator. So physician should use this tool with clinical experience.

摘要

在全球范围内,大量患者患有乳腺肿块,且这一趋势正在逐渐增加。从临床评估很难确定肿块是良性还是恶性。因此,出现了对微观组织分析的需求。本研究旨在确定细针穿刺细胞学检查在乳腺肿块诊断中的价值,并将细针穿刺抽吸活检(FNAC)的结果与组织病理学诊断结果进行比较,以评估其准确性。在2009年1月至2010年12月期间进行了一项前瞻性研究。选择了110名在两年内前往孟加拉国迈门辛医学院医院外科就诊的、乳房有可触及肿块的患者进行研究。在细针穿刺抽吸活检中,有70例(63.63%)为良性,33例(30.00%)为恶性,7例(6.36%)为可疑涂片。对样本不足的情况进行了重复操作。重复操作提高了抽吸物的诊断准确性,与组织病理学相比具有统计学意义。在组织病理学中,浸润性导管癌是最常报告的病变,在第四、第五和第六个十年发病率最高,其次是浸润性小叶癌和其他恶性病变。细针穿刺抽吸活检是诊断可触及乳腺病变的一种快速、经济且可靠的工具,其可靠性受抽吸者技术水平的影响。因此,医生应结合临床经验使用这一工具。

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