Roberts J C, Rainsbury R M
Royal Hampshire County Hospital, Winchester.
Ann R Coll Surg Engl. 1994 Mar;76(2):136-8.
The tactile sensation (TS) felt during fine needle aspiration (FNA) of symptomatic breast abnormalities was recorded prospectively in 169 patients. TS was classified as malignant (if 'gritty'), or benign (if 'rubbery', 'soft' or 'fibrous'). This assessment was compared with fine needle aspiration cytology (FNAC) and the final diagnosis, to evaluate the clinical utility of TS. A 'gritty' TS was recorded in 55/59 cancers and 22/110 benign lesions (sensitivity 93.2%, specificity 80%). Comparison of TS and FNAC in 69 patients with definitive histopathology revealed complementary results (TS, sensitivity 88.9%, specificity 48.5%; FNAC, sensitivity 55.6%, specificity 100%). Combining the sensitivity of TS with that of FNAC increased the overall sensitivity to 97.2%. Recording TS during FNA of symptomatic breast lumps enhances diagnosis, and alerts the clinician to the possibility of an underlying carcinoma when FNAC fails to confirm malignancy.
前瞻性记录了169例有症状乳腺异常患者在细针穿刺抽吸（FNA）过程中感受到的触觉感觉（TS）。TS被分类为恶性（如果是“沙砾样”）或良性（如果是“橡胶样”、“柔软”或“纤维样”）。将该评估结果与细针穿刺抽吸细胞学检查（FNAC）及最终诊断进行比较，以评估TS的临床应用价值。在59例癌症患者中有55例记录到“沙砾样”TS，在110例良性病变患者中有22例记录到（敏感性93.2%，特异性80%）。对69例有明确组织病理学结果的患者进行TS与FNAC比较，结果显示二者具有互补性（TS，敏感性88.9%，特异性48.5%；FNAC，敏感性55.6%，特异性100%）。将TS的敏感性与FNAC的敏感性相结合，可使总体敏感性提高至97.2%。在有症状乳腺肿块的FNA过程中记录TS可提高诊断率，并在FNAC未能确诊恶性肿瘤时提醒临床医生存在潜在癌的可能性。
