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目的探讨积乳症与乳管内乳头状瘤(病)的相关性。方法对2004年1月至2005年11月,经乳管镜诊断积乳症316例,应用乳管镜对溢乳以及合并乳头浆液性、血性溢液的病人进行检查,并选择部分病例进行乳管液雌孕激素受体检测及血清泌乳素测定。结果镜下诊断积乳症316例,积乳症合并乳管内乳头状瘤16例,合并多发性乳头状瘤2例,合并乳管内乳头状瘤病3例。手术21例,术后病理诊断乳管内乳头状瘤14例,乳头状瘤病3例,乳管炎伴炎性肉芽肿3例,乳腺腺病合并乳管扩张1例。行乳管脱落细胞雌孕激素受体检测93例,受体阳性79例;行泌乳素检测32例,21例垂体泌乳素高于正常范围,7例MRI检查脑垂体异常。结论乳管镜诊断积乳症直观、准确,可同时完成乳管内治疗,并能及时发现乳管内占位性病变。根据乳管液雌孕激素受体表达情况及血清泌乳素水平可推测积乳症与乳管内乳头状病变具有内在的相关性,有共同的发病基础。对积乳症须积极治疗,减少乳管内病变的发生率。
Objective To investigate the correlation between accumulated milk disease and intraductal papilloma (disease). Methods From January 2004 to November 2005, 316 cases of mastoid disease were diagnosed by ducting bronchoscopy. The patients with galactorrhea and serous and bloody discharge were examined by ductoscopy, and some cases were selected for ductal Detection of serum estrogen and progesterone receptors and serum prolactin. The results of microscopic diagnosis of lactating disease in 316 cases, accumulating milk combined with intraductal papilloma in 16 cases, with multiple papilloma in 2 cases, combined with intraductal papilloma in 3 cases. Surgery in 21 cases, postoperative pathological diagnosis of intraductal papilloma in 14 cases, 3 cases of papillomatosis, 3 cases of ductal inflammation with inflammatory granuloma, breast adenosis with ductal expansion in 1 case. 93 cases of estrogen and progesterone receptor were detected in the ductal exfoliated cells, 79 cases were positive, 32 cases of prolactin were detected, 21 cases of pituitary prolactin were higher than the normal range, and 7 cases were abnormality of pituitary gland. Conclusion Dyspepsia diagnosis of lactalbuminism intuitive and accurate, can be completed at the same time intraductal treatment, and timely detection of space-occupying lesions in the duct. According to the expression of estrogen and progesterone receptor in the esophageal fluid and serum prolactin level, it can be speculated that there is an internal correlation between the accumulative milk disease and the intraductal papillary lesion and the common pathogenesis. Positive treatment of accumulated milk to reduce the incidence of intraductal lesions.