男性乳腺癌检测中 tru-cut 活检与细针穿刺细胞学检查的前瞻性评估。
A Prospective Evaluation of Tru-Cut Biopsy and Fine-needle Aspiration Cytology in Male Breast Cancer Detection.
机构信息
Department of Biomedicine and Prevention, Division of Diagnostic Imaging, Policlinico Tor Vergata (PTV) University, Rome, Italy.
Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata (PTV) University, Rome, Italy.
出版信息
In Vivo. 2020 Nov-Dec;34(6):3431-3439. doi: 10.21873/invivo.12182.
BACKGROUND
Male breast-cancer (MBC) is often diagnosed late. Our purpose was to evaluate fine-needle aspiration cytology (FNAC) versus Tru-Cut biopsy (TCNB) in MBC diagnosis.
PATIENTS AND METHODS
Men with suspicious breast lesions were prospectively enrolled; 54 met the inclusion criteria and underwent FNAC and TCNB. FNAC, TCNB and gold-standard results were compared.
RESULTS
Unsatisfactory results were 11.1% after FNAC and none after TCNB (p=0.027). After gold-standard evaluation, the diagnosis of FNAC and TCNB was confirmed, respectively, in 63.0% and 98.1% and changed in 37.0% and 1.9% (p<0.001). The malignancy rate after FNAC, TCNB and surgery were, respectively, 25.9%, 33.3% and 35.1% (FNAC vs. TCNB p=0.5276, FNAC vs. surgery p=0.404; TCNB vs. surgery p=1). Among invasive carcinomas, 93.8% were identified by FNAC vs. 87.5% by TCNB (p=1); all ductal carcinoma in situ (DCIS) were detected after TCNB and none after FNAC (p=0.1).
CONCLUSION
FNAC leads to a significantly higher number of inadequate samplings and seems to be subject to increased DCIS misdiagnoses. TCNB correlated better to the final histological report.
背景
男性乳腺癌（MBC）通常诊断较晚。我们的目的是评估细针穿刺细胞学（FNAC）与环钻活检（TCNB）在 MBC 诊断中的作用。
患者与方法
前瞻性纳入有可疑乳腺病变的男性；54 名符合纳入标准的患者接受了 FNAC 和 TCNB 检查。比较 FNAC、TCNB 和金标准结果。
结果
FNAC 后不满意的结果为 11.1%，而 TCNB 后则无（p=0.027）。经金标准评估，FNAC 和 TCNB 的诊断分别在 63.0%和 98.1%的患者中得到证实，分别有 37.0%和 1.9%的患者诊断发生改变（p<0.001）。FNAC、TCNB 和手术的恶性肿瘤发生率分别为 25.9%、33.3%和 35.1%（FNAC 与 TCNB 相比，p=0.5276，FNAC 与手术相比，p=0.404；TCNB 与手术相比，p=1）。在浸润性癌中，FNAC 可识别 93.8%，而 TCNB 可识别 87.5%（p=1）；所有导管原位癌（DCIS）均经 TCNB 检出，而 FNAC 无一例检出（p=0.1）。
结论
FNAC 导致的样本不足的情况明显更多，且似乎更容易误诊 DCIS。TCNB 与最终的组织学报告相关性更好。
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