Feichter G E, Haberthür F, Gobat S, Dalquen P
Division of Gynecological Cytology, University of Basel, Switzerland.
Acta Cytol. 1997 Mar-Apr;41(2):327-32. doi: 10.1159/000332520.
To analyze the sensitivity, specificity, positive and negative predictive values and the efficacy of fine needle aspiration (FNA) in our material, to investigate the influence of the histologic type and stage of carcinoma on the quality of the aspirates and on the detection rates of mammary carcinoma, and to investigate the rate of inadequate samples and the accuracy of cytologic diagnoses, with an emphasis on the rate of false positive diagnoses in benign mammary lesions.
The results of 1,472 FNAs of the breast obtained over three years were subjected to a retrospective analysis.
The cytologic diagnoses were benign in 1,003 cases (68.1%), suspicious in 49 (3.3%) and malignant in 181 (12.3%); 239 (16.2%) of the aspirates were inadequate. In 393 (26.6%) of the cases and in 85% of cytologically malignant smears, the aspirate was compared with histologic examination. The rate of false negative FNAs was 9.0%. The proportion of inadequate cases was clearly related to stage (pT): it was 9.5% in pT1, 5.0% in pT2 and 0% in pT3. Among invasive carcinomas the sensitivity was 89.9%, specificity 99.3% and overall accuracy 88.5%. Among the cases diagnosed cytologically as benign, 182 were compared with biopsies. Of these, 79.9% were true negative, 0.5% (1 case) was false positive, and 15.4% had insufficient cells for evaluation.
FNA cytology has improved decision making and the selection of patients for biopsy of mammary lesions and has contributed to saving time in the clinical management of breast lumps. In no case did FNA lead to inadequate clinical measures or other disadvantages to patients. Thus, FNA cytology is an indispensible diagnostic tool in the management of breast lesions.
分析我们所收集样本中细针穿刺抽吸术（FNA）的敏感性、特异性、阳性和阴性预测值以及有效性，研究癌组织学类型和分期对抽吸物质量及乳腺癌检出率的影响，调查样本不足率和细胞学诊断的准确性，重点关注良性乳腺病变的假阳性诊断率。
对三年间获取的1472例乳腺FNA结果进行回顾性分析。
细胞学诊断为良性的有1003例（68.1%），可疑的有49例（3.3%），恶性的有181例（12.3%）；239例（16.2%）抽吸物样本不足。393例（26.6%）病例及85%细胞学诊断为恶性的涂片与组织学检查结果进行了对比。FNA假阴性率为9.0%。样本不足病例的比例与分期（pT）明显相关：pT1期为9.5%，pT2期为5.0%，pT3期为0%。浸润性癌中，敏感性为89.9%，特异性为99.3%，总体准确率为88.5%。在细胞学诊断为良性的病例中，182例与活检结果进行了对比。其中，79.9%为真阴性，0.5%（1例）为假阳性，15.4%细胞数量不足无法评估。
FNA细胞学检查有助于改善乳腺病变活检患者的决策制定和选择，节省了乳腺肿块临床管理的时间。FNA从未导致临床措施不当或给患者带来其他不利影响。因此，FNA细胞学检查是乳腺病变管理中不可或缺的诊断工具。
