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目的探讨彩超引导下空芯针穿刺活检(CNB)对早期乳腺癌诊治的临床应用。方法选取自2009年1月至2012年12月于该院乳腺外科行彩超定位下巴德针穿刺活检的92例样本,分析其与术后病理的诊断一致性、阳性预测值、阴性预测值、特异度、敏感度、假阴性率、低估率等指标,并对确诊为乳腺癌的患者行ER、PR、Her-2、Ki-67等免疫组织化学检测,与术后免疫组化检测结果进行对比,分析其诊断价值。结果 (1)CNB诊断准确率为98.91%,对乳腺恶性肿瘤的敏感度98.36%,特异度100%,阳性预测值100%,阴性预测值96.97%,假阴性率3.125%,低估率4.918%;(2)空芯针穿刺与手术切除标本的病理诊断结果与ER、PR、Her-2、Ki-67对比,在表达一致性上无统计学差异(P>0.05)。结论 (1)乳腺肿物患者术前采用彩超定位行CNB创伤小,操作简单,病理诊断准确率高,可以替代术后大病理的诊断结果;(2)术前CNB ER、PR、Her-2、Ki-67结果可以准确反映术后大病理的免疫组化检测结果。
Objective To investigate the clinical application of color core guided core needle biopsy (CNB) in diagnosis and treatment of early breast cancer. Methods From January 2009 to December 2012, 92 patients underwent needle biopsy under color Doppler ultrasonography in the Department of Breast Surgery of the Hospital from January 2009 to December 2012. The diagnostic consistency, positive predictive value, negative predictive value, Specificity, sensitivity, false negative rate, underestimation rate and other indicators, and breast cancer patients diagnosed with ER, PR, Her-2, Ki-67 and other immunohistochemical detection, and immunohistochemical detection results Compare and analyze its diagnostic value. Results (1) The diagnostic accuracy rate of CNB was 98.91%, the sensitivity of which was 98.36%, the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 96.97%, the false negative rate was 3.125% and the underestimation rate was 4.918%. (2) There was no significant difference (P> 0.05) in the consistency between the pathological diagnosis of hollow core needle puncture and surgical resection specimens and ER, PR, Her-2 and Ki-67. Conclusions (1) Preoperative ultrasound with color Doppler ultrasound localization line CNB trauma, simple operation, high accuracy of pathological diagnosis, can replace the postoperative pathological diagnosis; (2) preoperative CNB ER, PR, Her-2 , Ki-67 results can accurately reflect the postoperative pathological immunohistochemical test results.