Lankford K V, Kluskens L, Dowlatshahi K, Reddy V B, Gattuso P
Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA.
Cancer. 1998 Apr 25;84(2):98-100. doi: 10.1002/(sici)1097-0142(19980425)84:2<98::aid-cncr5>3.0.co;2-9.
Several reports have compared the results of fine-needle aspiration and stereotactic core needle biopsy in nonpalpable breast lesions. In this study the authors describe a simple method to retrieve cytologic material from a core breast biopsy sample that provides the diagnosis within 1 hour of the procedure.
Two hundred and eleven nonpalpable breast lesions were biopsied. Each core needle biopsy sample was placed in a mesh bag, and the bag and needle notch were washed in Cytolyt solution to obtain a monolayer using a commercial ThinPrep processor. The cytologic diagnoses were divided into four categories: benign, suspicious, malignant, and unsatisfactory, which then were compared with core needle biopsy results.
Cytology reports of 211 lesions were as follows: 169 lesions (80%) were benign, 16 lesions (7.6%) were suspicious, 11 lesions (5.2%) were malignant, and 15 lesions (7.1%) were unsatisfactory. Core needle biopsy showed 165 of 169 samples (98%) to be benign and 4 to be malignant. Of the 16 suspicious smears, 10 were invasive carcinoma, 2 were in situ lesions, 3 were hyperplasias, and 1 was fibrosis. Of the 11 malignant smears, 10 were confirmed on core needle biopsy and 1 was read as atypia on the first core needle biopsy sample and malignant on a second, separate, follow-up core needle biopsy. Of the 15 unsatisfactory samples, 14 were found to be benign and 1 was found to be malignant on a separate, follow-up core needle biopsy.
The core wash technique was 85% sensitive and 98% specific for malignancy. Only 7% of specimens were insufficient for diagnosis, and 93% of these were proven to be benign. This technique is useful for immediate (within 1 hour) diagnosis of breast lesions, alleviating patient anxiety and supplementing the diagnostic yield of the core biopsy.
多项报告比较了细针穿刺活检和立体定向粗针活检在不可触及乳腺病变中的结果。在本研究中，作者描述了一种从乳腺粗针活检样本中获取细胞学材料的简单方法，该方法可在操作后1小时内做出诊断。
对211例不可触及的乳腺病变进行活检。将每个粗针活检样本置于网袋中，使用商用ThinPrep处理器，将袋子和针槽在Cytolyt溶液中冲洗以获得单层细胞。细胞学诊断分为四类：良性、可疑、恶性和不满意，然后将其与粗针活检结果进行比较。
211例病变的细胞学报告如下：169例（80%）为良性，16例（7.6%）为可疑，11例（5.2%）为恶性，15例（7.1%）为不满意。粗针活检显示，169个样本中有165个（98%）为良性，4个为恶性。在16例可疑涂片样本中，10例为浸润性癌，2例为原位病变，3例为增生，1例为纤维化。在11例恶性涂片样本中，10例经粗针活检确诊，1例在首次粗针活检样本中被诊断为非典型增生，在第二次单独的随访粗针活检中被诊断为恶性。在15例不满意样本中，14例在单独的随访粗针活检中被发现为良性，1例为恶性。
粗针冲洗技术对恶性病变的敏感性为85%，特异性为98%。只有7%的标本诊断不足，其中93%被证明为良性。该技术有助于乳腺病变的即时（1小时内）诊断，减轻患者焦虑，并提高粗针活检的诊断率。
