摘要
目的分析纤维乳管镜与乳腺超声对伴有乳头溢液的乳管内占位性病变的临床诊断价值。方法选取2021年3月—2022年10月在无锡市惠山区人民医院就诊的乳头溢液患者59例共77个乳房为研究对象。所有研究对象均接受乳腺超声和纤维乳管镜检查,以病理诊断或临床随访作为诊断的“金标准”,对两种诊断方法单一及联合检查对伴有乳头溢液乳管内占位性病变的诊断价值进行分析。结果59例患者的77个乳房中33个行手术取得病理结果,阳性25个,阴性8个。无病理结果44个,经随访,均表现阴性。恶性病变以血性溢液为主,占83.33%(5/6),导管内乳头状瘤及乳腺病以浆液性溢液为主,分别为63.16%(12/19),87.50%(7/8)。超声联合纤维乳管镜对本病诊断的灵敏度为100.00%,特异度为84.62%,正确率89.61%,均高于单纯超声检查或纤维乳管镜检查。纤维乳管镜对本病诊断的灵敏度(96.00%)、特异度(76.92%)和正确率(83.12%)均高于超声。纤维乳管镜的误诊率(23.08%)低于超声(26.92%),二者联合检查的误诊率(15.38%)最低,超声对本病诊断的漏诊率(28.00%)最高,纤维乳管镜的漏诊率(4.00%)显著较低,联合检查的漏诊率为0。结论纤维乳管镜联合乳腺超声对伴有乳头溢液的乳管内占位性病变患者具有较高的临床诊断价值,能够为病理性乳头溢液患者的随访和临床管理提供重要依据。
Objective To analyze the clinical diagnostic value of fiberoptic ductoscopy and mammary ultrasound for space occupying lesions in mammary duct with nipple discharge.Methods 59 patients with nipple discharge admitted to Wuxi Huishan District People's Hospital from March 2021 to October 2022 were selected,with a total of 77 breasts.All subjects underwent breast ultrasound and fiberoptic ductoscopy.Taking pathological diagnosis or clinical follow-up as the"gold standard"of diagnosis,the diagnostic value of two methods for single and joint inspection for space occupying lesions in mammary duct with nipple discharge was analyzed.Results Among 77 breasts of 59 patients,33 were surgically performed and pathological results were obtained,25 were positive and 8 were negative.No pathological findings were found in 44 cases,all of which were negative after follow-up.The majority of malignant lesions were hemorrhagic discharge,accounting for 83.33%(5/6),while the majority of intraductal papilloma and breast diseases were serous discharge,accounting for 63.16%(12/19)87.5%(7/8)respectively.The sensitivity,specificity and accuracy of ultrasound combined with fiberoptic ductoscopy were 100.00%,84.62%and 89.61%,which were higher than ultrasound alone or fiberoptic ductoscopy.The sensitivity(96.00%),specificity(76.92%)and accuracy(83.12%)of fiberoptic ductoscopy were higher than those of ultrasound.The misdiagnosis rate of fiberoptic ductoscopy(23.08%)was lower than that of ultrasound(26.92%),and the misdiagnosis rate of combined examination(15.38%)was the lowest.The missed diagnosis rate of ultrasound was the highest(28.00%),the missed diagnosis rate of fiberoptic ductoscopy(4.00%)was significantly lower,and the missed diagnosis rate of combined examination was 0.Conclusion Fiberoptic ductoscopy combined with breast ultrasound has a high clinical diagnostic value for the patients with space occupying lesions in the milk duct accompanied by nipple discharge,and can provide an important basis for the follow-up and clinical management of patients with pathological nipple discharge.
作者
朱星梦
张镓薇
呼奶英
ZHU Xingmeng;ZHANG Jiawei;HU Naiying(Department of Ultrasound,Wuxi Huishan District People's Hospital,Wuxi,Jiangsu Province,214000 China)
出处
《世界复合医学》
2023年第10期76-79,83,共5页
World Journal of Complex Medicine
关键词
乳头溢液
纤维乳管镜
超声
占位性病变
Nipple discharge
Fiberoptic ductoscopy
Ultrasound
Space occupying lesion
