Park Shin-Young, Ko SeungSang, Yoon Chan Seok, Lee Hae Kyung, Kang Sung Soo, Hur Min Hee
Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea.
Gland Surg. 2020 Aug;9(4):919-924. doi: 10.21037/gs-20-310.
Traditionally, surgical excision is recommended for benign papillary lesions in core-needle biopsy (CNB) because of their malignant potency. The aim of this study was to identify factors associated with disease upgrading to malignancy in patients with benign papillary lesions in CNB.
A total of 179 female patients were evaluated retrospectively who were diagnosed as having a benign papillary lesion in CNB and underwent a subsequent surgical excision between January 2007 and December 2016. Ultrasonography-guided CNB was performed using a 14-gauge needle gun method.
The rate of upgrade to malignancy was 10.6% (7.6% in papillary lesions without atypia 33.3% in papillary lesions with atypia; P=0.001). The univariable analysis revealed that older age at diagnosis (≥50 years old), menopause, lesion size on ultrasonography, palpability, multifocality, and atypia in CNB were associated with upgrading. The multivariable analysis revealed that age ≥50 years (OR, 4.6; 95% CI, 1.5-14.1; P=0.008), lesion size of ≥2 cm (OR, 6.4; 95% CI, 1.9-21.1; P=0.002), and atypia in CNB (OR, 5.1; 95% CI, 1.5-18.2; P=0.011) were significantly associated with upgrading to malignancy.
Upgrading to malignancy in patients with benign papillary lesions in CNB was associated with age ≥50 years, lesion size ≥2 cm, and atypia in CNB.
传统上，由于其恶性潜能，对于粗针活检（CNB）中诊断为良性乳头状病变的患者，建议进行手术切除。本研究的目的是确定CNB中诊断为良性乳头状病变的患者疾病进展为恶性的相关因素。
回顾性评估了2007年1月至2016年12月期间共179例经CNB诊断为良性乳头状病变并随后接受手术切除的女性患者。采用14G针枪法进行超声引导下CNB。
恶性升级率为10.6%（无异型性的乳头状病变为7.6%，有异型性的乳头状病变为33.3%；P=0.001）。单因素分析显示，诊断时年龄较大（≥50岁）、绝经、超声检查时的病变大小、可触及性、多灶性以及CNB中的异型性与升级有关。多因素分析显示，年龄≥50岁（OR，4.6；95%CI，1.5-14.1；P=0.008）、病变大小≥2cm（OR，6.4；95%CI，1.9-21.1；P=0.002）以及CNB中的异型性（OR，5.1；95%CI，1.5-18.2；P=0.011）与恶性升级显著相关。
CNB中良性乳头状病变患者的恶性升级与年龄≥50岁、病变大小≥2cm以及CNB中的异型性有关。
