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目的比较乳腺癌术前早期诊断的方法,探讨筛选的指征,以提高乳腺癌术前早期诊断准确率和患者生存率。方法回顾性分析10余年我院358例乳癌术前诊断方法及结果情况。结果358例运用现有的诊断方式进行术前诊断的仅176例,不到50%;运用穿刺细胞学检查及钼钯等准确性较高的检查方式的79例,占总病例数的25%左右;真正得到术前确诊的32例,不到10%;约90%的病例均采取了肿块切取活检的方式。结论目前临床上惯用的肿块切取活检方式使很大的一部分病人失去了术前治疗的机会,也阻碍了新的治疗方法在临床上的应用。红外线及B超检查虽在临床上使用较多,但准确率较低,只能作为常规筛选病例而用,应辅以更为可靠的检查方法。穿刺细胞学检查及钼钯检查准确率较高,简便易行,应作为常规检查方法在临床上广泛开展,并应结合其他诊断方法如乳腺彩超等综合使用以提高确诊率。并提出了在穿刺方式及标本固定技术上的一点小小改进。
Objective To compare the preoperative diagnosis of breast cancer and explore the indications for screening to improve the accuracy of early diagnosis of breast cancer and the survival rate of patients. Methods Retrospective analysis of more than 10 years in our hospital 358 cases of breast cancer preoperative diagnosis methods and results. Results Of the 358 cases, only 176 cases (less than 50%) were diagnosed preoperatively by using the existing diagnostic methods. 79 cases were diagnosed by puncture cytology and molybdenum-palladium with high accuracy, accounting for 25% About 32 cases were diagnosed before surgery, less than 10%; about 90% of the cases were taken by the mass biopsy approach. Conclusion Currently, the most commonly used lump biopsy method has lost a large part of patients the chance of preoperative treatment and hindered the clinical application of new treatment methods. Although the use of infrared and B-ultrasound more clinically, but the accuracy is low, only as a routine screening cases and should be supplemented by more reliable inspection methods. Puncture cytology and molybdenum palladium examination accuracy is high, simple and easy, and should be widely used as a routine examination in clinical practice, and should be combined with other diagnostic methods such as combined use of mammography to improve the diagnosis rate. And put forward a little improvement in puncture method and specimen fixing technique.