【摘要】：目的探討超聲引導(dǎo)下穿刺活檢診斷乳腺癌前病變的準(zhǔn)確性及提示病變可能被低估的超聲表現(xiàn)。方法收集經(jīng)超聲引導(dǎo)下穿刺活檢的乳腺腫物患者605例,記錄腫物的超聲表現(xiàn),將穿刺病理結(jié)果與術(shù)后病理或隨訪結(jié)果進(jìn)行對比。結(jié)果除3例患者因組織過少未獲得穿刺病理診斷外,602例患者的穿刺病理與術(shù)后病理或隨訪結(jié)果對比,符合率為97.84%(589/602),兩者間一致性較好(Kappa=0.96,P=0.01)。穿刺活檢結(jié)果為癌前病變者與術(shù)后病理或隨訪結(jié)果對比符合組32例,低估組10例,低估率為23.81%(10/42)。符合組和低估組癌前病變的鈣化、后方回聲衰減、血流、可疑淋巴結(jié)在兩組間差異有統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論超聲引導(dǎo)下穿刺活檢對診斷乳腺腫物的準(zhǔn)確率較高,但對癌前病變存在一定低估,尤其對于超聲表現(xiàn)有惡性特征的癌前病變應(yīng)考慮低估的可能。
[Abstract]:Objective to investigate the accuracy of ultrasound guided biopsy in the diagnosis of precancerous lesions and to suggest that the lesions may be underestimated. Methods Sixty-five patients with mammary gland mass underwent ultrasound guided biopsy. Ultrasonic findings were recorded and compared with those of postoperative pathology or follow-up. Results except for 3 cases whose biopsy was not diagnosed by biopsy because of lack of tissue, the coincidence rate was 97.84% (589 / 602), and the consistency between the two was better (Kappa 0.96%, P0.01) than that of postoperative pathology or follow-up (P 0.01). The results of puncture biopsy were compared with those of postoperative pathology or follow-up in 32 cases, and 10 cases in the undervalued group, and the underestimation rate was 23.81% (10 / 42). There were significant differences in calcification, posterior echo attenuation, blood flow and suspected lymph nodes between the two groups (P 0.05). Conclusion Ultrasound-guided biopsy is accurate in the diagnosis of breast masses, but it may be underestimated for precancerous lesions, especially for precancerous lesions with malignant features.
【作者單位】： 青島大學(xué)附屬煙臺毓璜頂醫(yī)院超聲科;
【分類號】：R445.1;R737.9

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