细针抽吸活检在腋窝肿块诊断中的应用。

The Application of Fine Needle Aspiration Biopsy in the Diagnosis of Axillary Masses.

机构信息

Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

Department of Orthopedics, Luzhou Traditional Chinese Medicine Hospital, Luzhou, China.

出版信息

Acta Cytol. 2021;65(3):213-219. doi: 10.1159/000513149. Epub 2021 Feb 3.

DOI:10.1159/000513149

PMID:33535203

Abstract

INTRODUCTION

We intend to determine the diagnostic power of fine needle aspiration biopsy (FNAB) for differentiation between malignant and benign lesions on axillary masses and draw the physicians' attention to the benefits of FNAB cytology in the diagnosis of axillary masses.

METHODS

In this study, 1,328 patients with an axillary mass diagnosed by FNAB were retrospectively reviewed. These cases were registered at the affiliated hospital of Southwest Medical University (China), July 2014 to June 2017. Cytological results were verified either by histopathology following surgical resection or clinical follow-up.

RESULTS

Of the 1,328 patients affected by axillary masses, 987 (74.3%) cases were female, and 341 (25.7%) cases were male. The highest incidence of patients was in the age group of 41-50 years (375, 28.2%). There were 1,129 (85.0%) patients with benign lesions and 199 (15.0%) with malignant lesions. Of the 199 malignant lesions cases, 21 cases were lymphomas, 2 cases were accessory breast cancers, and 176 cases were lymph node metastatic tumors. Under lymph node metastases, the most frequent primary tumors were breast cancer (141, 80.1%), followed by lung cancer (21, 11.9%). According to the study, the characters of 1,328 cases showed statistically significant difference (χ2 = 4.534, p = 0.033), and the incidence of females with axillary mass was significantly higher than that of males. There was a statistically significant difference in the distribution of benign and malignant cases in the patient age groups (χ2 = 1.129, p = 0.000), and the incidence of patients of 41-50 years of age was significantly higher than that of other patients. The diagnostic accuracy of FNAB in axillary masses was analyzed with the results of 95.98% of sensitivity, 99.56% of specificity, 97.45% of positive predictive value, and 99.29% of negative predictive value.

CONCLUSION

Our results confirm that FNAB is a valuable initial screening method regarding pathologic diagnosis of axillary mass, in particular with respect to malignancy in 41- to 50-year-old female patients.

摘要

简介

我们旨在确定细针抽吸活检（FNAB）在区分腋窝肿块的良恶性病变方面的诊断能力，并提请医生注意 FNAB 细胞学在腋窝肿块诊断中的益处。

方法

本研究回顾性分析了 1328 例经 FNAB 诊断为腋窝肿块的患者。这些病例于 2014 年 7 月至 2017 年 6 月在西南医科大学附属医院登记。细胞学结果通过手术切除后的组织病理学或临床随访进行验证。

结果

在 1328 例腋窝肿块患者中，987 例（74.3%）为女性，341 例（25.7%）为男性。发病率最高的人群为 41-50 岁年龄组（375 例，28.2%）。1129 例（85.0%）为良性病变，199 例（15.0%）为恶性病变。在 199 例恶性病变中，21 例为淋巴瘤，2 例为副乳腺癌，176 例为淋巴结转移瘤。在淋巴结转移中，最常见的原发性肿瘤是乳腺癌（141 例，80.1%），其次是肺癌（21 例，11.9%）。研究表明，1328 例患者的特征有统计学显著差异（χ2 = 4.534，p = 0.033），女性腋窝肿块的发病率明显高于男性。良性和恶性病例在患者年龄组中的分布有统计学显著差异（χ2 = 1.129，p = 0.000），41-50 岁年龄组的发病率明显高于其他年龄组。FNAB 对腋窝肿块的诊断准确率为灵敏度 95.98%，特异性 99.56%，阳性预测值 97.45%，阴性预测值 99.29%。