超声引导下粗针活检术在乳腺叶状肿瘤诊断中的应用

摘要

PurposeTo explore the application of ultrasonography-guided core needle biopsy (US-CNB) in diagnosis of breast phyllodes tumor, in order to provide a reliable basis for operation selection, and to improve prognosis.Materials and MethodsFifty-seven patients with diagnosed or suspected phyllodes tumor of the breast (PTB) were retrospectively studied. Ultrasound results and US-CNB biopsy data were compared with surgical pathology results.ResultsFor all the 57 cases of PTB, US-CNB revealed 46 benign cases, 8 cases of suspected borderline PTB, and 3 cases of mesenchymal malignant tumors. The postoperative pathological diagnosis of all the patients included 48 cases of benign tumors, 6 cases of borderline tumors, and 3 cases of malignant tumors. Compared with the postoperative pathology, US-CNB had sensitivity of 95.83%, speciifcity of 100.00%, the coincidence rate of 96.49%, the misdiagnosis rate of 4.17%, and misdiagnosis rate of 0%. The Youden's index was 0.96, andKappa was 0.8345. ConclusionUS-CNB has high sensitivity, speciifcity and coincidence rate in diagnosis of PTB.%目的：探讨超声引导下粗针活检术（US-CNB）在乳腺叶状肿瘤（PTB）诊断中的应用价值，为临床选择手术方案提供可靠依据，提高患者预后。资料与方法回顾性分析US-CNB明确诊断或倾向性诊断为PTB的57例患者的超声与病理资料，并与手术病理结果进行对照。结果57例PTB患者中，US-CNB诊断46例为良性PTB，8例不除外交界性PTB可能，3例为间叶源性恶性肿瘤，需除外恶性PTB；术后病理48例诊断为良性PTB，6例为交界性，3例为恶性；与术后病理诊断结果相比， US-CNB诊断PTB的敏感度为95.83%，特异度为100.00%，符合率为96.49%，漏诊率为4.17%，误诊率为0，Youden指数为0.96，Kappa值为0.8345。结论 US-CNB诊断PTB的敏感度、特异度及符合率较高，具有较大的临床应用价值。