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目的探讨立位X线立体定位真空辅助空心针活检术在诊断乳腺微小钙化性病变中的作用。方法对2001年～2005年在日本东北大学进行活检的159例微小钙化性病变进行回顾性分析。结果共有97.4%的穿刺活检标本经活检后X线检查和病理学证实有微小钙化。穿刺标本的病理结果显示:154例中98例(63.6%)为良性,51例(33.1%)为乳腺癌,3例(1.9%)为不典型增生,2例为不能明确诊断。有48例接受了手术,其中36例穿刺活检诊断为导管原位癌的病例中有6例(16.7%)手术证实为导管浸润癌,2例穿刺活检诊断为不典型增生的病变,手术证实有1例为原位癌。X线立体定位真空辅助穿刺活检术诊断乳腺癌浸润的阳性预测值为100%。活检为良性的病变,平均随访22个月,未见恶性病例。操作过程中的并发症主要为神经血管综合征(6.3%),术中出血(0.6%),和活检术后血肿(2.6%)。结论立位X线立体定位真空辅助空心针活检术简便,准确。对乳腺微小钙化性病变是最佳的诊断方法,可以取代手术活检。
Objective To investigate the role of vacuum-assisted hollow needle biopsy in the diagnosis of microcalcification of breast by using orthostatic X-ray positioning. Methods A retrospective analysis was performed on 159 patients with microcalcifications undergoing biopsy at Northeastern University from 2001 to 2005. Results A total of 97.4% of biopsy specimens were examined by X-ray after biopsy and confirmed by pathology microcalcifications. Pathological findings of the puncture specimens showed that 98 of 154 (63.6%) were benign, 51 (33.1%) were breast cancer, 3 (1.9%) were atypical hyperplasia and 2 were not diagnosed correctly. Sixty-eight cases (16.7%) were diagnosed as invasive ductal carcinoma by ductal biopsy and two cases were diagnosed as atypical hyperplastic lesions by biopsy. The operation confirmed that there were 1 case of carcinoma in situ. X-ray stereotactic vacuum-assisted biopsy diagnosis of breast cancer infiltration of the positive predictive value of 100%. Biopsy of benign lesions, with an average follow-up of 22 months, no malignant cases. Complications during operation were mainly neurovascular syndrome (6.3%), intraoperative bleeding (0.6%), and post-biopsy hematomas (2.6%). Conclusion The position X-ray positioning vacuum assisted hollow needle biopsy is simple and accurate. Small breast calcification of the disease is the best diagnostic method, you can replace the surgical biopsy.