摘要
目的 探讨印片细胞学对 4种易误诊的乳腺良性病变在术中诊断的价值。方法 乳腺肿块术中快速冷冻切片 ,同时做细胞印片检查 ,并计算各自诊断的准确性。结果 在 2 3例导管内乳头状瘤病中 ,冷冻切片显示导管内乳头状增生活跃 ,部分区域难与癌相鉴别 ,诊断特异性为 78 3% ( 18/ 2 3) ;印片细胞学涂片显示细胞异型程度为轻～中度 ,细胞团中可见肌上皮混杂 ,诊断特异性为 91 3 % ( 2 1/ 2 3) ,差异显著。在 33例硬化性腺病及放射状瘢痕中 ,冷冻切片仍显示与硬癌难以鉴别 ,诊断特异性为 75 8% ( 2 5 / 33) ;印片细胞学涂片可见肌上皮成分和细胞异型性不明显的特征 ,在浸润性癌及小管癌时可见恶性细胞学特征 ,诊断的特异性为 90 9% ( 30 / 33) ,差异显著。结论 术中印片细胞学检查 ,能够清楚显示乳腺良恶性肿瘤的细胞学特征 ,可防止冷冻切片过诊断的发生。
Objective To evaluate the value of touch preparation in cytological diagnosis of the breast lesions which was easily misdiagnosed. Methods While processing frozen section of breast tumors, a touch preparation was made in the same time. Accuracy rate of the both methods was compared for the diagnosis. Results Among 23 cases of intraductal papillomatosis,the frozen sections showed the florid proliferation existed in the ducts, which was difficult to distinguish from carcinoma, and its accuracy rate of diagnosis was 78.3%(18/23). Cytology in the touch preparations demonstrated that the tumor cells had mild to moderate atypia, mixed with myoepithelium, and its accuracy rate of diagnosis reached 91.3%(21/23). There was a significant difference between the methods. It was difficult to differentiate sclerosing adenosis and radiate scar from sirrhous carcinoma in frozen sections, in which the rate of specific diagnosis was 75.8%(25/33). But touch preparation had capacity to show myoepithelial cells and cells without atypia in the benign lesions, as well as malignant characteristics of the cells in the carcinoma, in which the rate of specific diagnosis was 90.9% (30/33). Conclusions Touch preparation is able to reveal the cytological features of benign and malignant cells in breast lesions, and prevents the misdiagnosis made by frozen section.
出处
《诊断病理学杂志》
CSCD
2003年第1期30-31,I009,共3页
Chinese Journal of Diagnostic Pathology
