Zou Shi-Fang, Tao Lin, Feng Zhen-Chu, Wang Ji-Yan, Liu Lin, Liang Wen-Long, Liu Jie-Na, Xu Dan-Dan, Lin Jia-Yan, Zhang Jian-Guo, Chen Xi
The 8 Ward of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Arch Med Sci. 2019 Aug 22;18(2):422-431. doi: 10.5114/aoms.2019.87096. eCollection 2022.
The present study aims to clarify the advantages and disadvantages of elite biopsy, to provide a reference for selecting the puncture method.
A total of 802 patients with a BI-RADS grade ≥ 4, as evaluated by the molybdenum target, and measurable lesions revealed by colour Doppler ultrasound, who were admitted at our department from January 2017 to January 2018, were enrolled in the present study. These patients were randomly divided into three groups: elite, Mammotome and core needle biopsy groups. The pathological underestimation rate, diagnostic accordance rate, haematoma incidence rate, and costs of these three biopsy methods were compared.
The difference in diagnostic accordance rates between the elite biopsy group and core needle biopsy group was statistically significant (98.9% vs. 94.7%, = 0.003), as well as between the Mammotome biopsy group and core needle biopsy group (99.6% vs. 94.7%, < 0.001). The difference in pathological underestimation rates between the elite biopsy group and core needle biopsy group was statistically significant (7.2% vs. 37.3%, < 0.001), as well as between the Mammotome biopsy group and core needle biopsy group (1.6% vs. 7.2%, < 0.001). The difference between the Mammotome biopsy group and elite biopsy group was not statistically significant. The incidence of haematoma in the Mommotome, elite, and core needle groups was 15.9%, 13%, and 21.7%, respectively (13% vs. 21.7%, = 0.021).
Elite biopsy has a low rate of pathological underestimation and low incidence of haematoma, can improve the breast conserving rate, and has an affordable cost. As a biopsy method with high accuracy, safety, and economy, elite biopsy can be widely used in clinics.
本研究旨在阐明精英活检的优缺点，为穿刺方法的选择提供参考。
选取2017年1月至2018年1月在我科住院的802例经钼靶评估BI-RADS分级≥4且经彩色多普勒超声显示有可测量病灶的患者纳入本研究。这些患者被随机分为三组：精英活检组、麦默通活检组和粗针活检组。比较这三种活检方法的病理低估率、诊断符合率、血肿发生率及费用。
精英活检组与粗针活检组的诊断符合率差异有统计学意义（98.9%对94.7%，P = 0.003），麦默通活检组与粗针活检组的诊断符合率差异也有统计学意义（99.6%对94.7%，P < 0.001）。精英活检组与粗针活检组的病理低估率差异有统计学意义（7.2%对37.3%，P < 0.001），麦默通活检组与粗针活检组的病理低估率差异也有统计学意义（1.6%对7.2%，P < 0.001）。麦默通活检组与精英活检组之间的差异无统计学意义。麦默通组、精英组和粗针组的血肿发生率分别为15.9%、13%和21.7%（13%对21.7%，P = 0.021）。
精英活检病理低估率低、血肿发生率低，可提高保乳率，且费用可承受。作为一种具有高准确性、安全性和经济性的活检方法，精英活检可在临床上广泛应用。
