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目的:探讨不可触及乳腺微小病变(NPBL)的定性诊断方法。方法:在乳腺钼靶X线机、高频超声或乳管镜引导下对146例152个NPBL进行定位穿刺活检(SCNB)或手术切除活检(NLOB),并对其资料进行分析。结果:病理诊断为乳腺癌43例共44个病灶;其中临床表现为乳腺局限性增厚者为60.5%;X线、超声及两者与乳管镜联合应用的敏感性和准确性分别为70.5%、77.0%,61.4%、65.8%和90.9%、97.4%;三种仪器联合应用的敏感性和准确性均较单种仪器高,其敏感性与超声比较差异显著(P<0.05),准确性与X线及超声比较差异均非常显著(P<0.001)。结论:乳腺局限性增厚是早期乳腺癌的重要表现,X线、超声和乳管镜联合应用可提高早期乳腺癌的检出率,SCNB和NLOB是NPBL定性诊断的有效方法。
Objective: To explore the qualitative diagnosis of non-palpable breast lesion (NPBL). Methods: 146 patients (152 NPBLs) underwent needle biopsy (SCNB) or surgical excision biopsy (NLOB) under the guidance of mammography, high frequency ultrasound or ductoscopy. The data were analyzed. Results: Pathological diagnosis of 43 cases of breast cancer 44 lesions; clinical manifestations of breast hyperplasia was 60.5%; X-ray, ultrasound and both combined with the use of ductoscopy sensitivity and accuracy were 70.5 %, 77.0%, 61.4%, 65.8% and 90.9%, 97.4%, respectively. The sensitivity and accuracy of the three instruments were higher than those of the other instruments, and the sensitivity and ultrasound were significantly different (P <0.05) There was significant difference between sex and X-ray and ultrasound (P <0.001). Conclusion: Localized thickening of mammary gland is an important manifestation of early breast cancer. Combined use of X-ray, ultrasonography and ductoscopy can improve the detection rate of early breast cancer. SCNB and NLOB are effective methods for the qualitative diagnosis of NPBL.