327例乳腺肿块针吸细胞学与组织学检查对比分析

目的:探讨乳腺针吸细胞学检查(FNAC)对乳腺癌诊断的准确性.方法:对1062例乳腺肿块行FNAC检查,其中327例获得病理组织学对照.结果:本组针吸细胞学检查敏感性为97.3%,特异性为95.0%,潜在假阴性率2.7%,符合率95.4%.结论:(1)针吸细胞学是检查乳腺肿块的一种重要的辅助诊断方法,但仍存在一定的局限性,对疑难病例需要通过病理组织学确诊.(2)肿块实质细胞较少或细胞异形性不明显是阴性诊断的主要原因.穿刺前详细询问病史,进行大体检查,精确选择穿刺部位,穿刺时仔细体会针感及重复针吸是减少假阴性的主要手段.     

穿刺细胞学与B超相结合在诊断乳腺癌中的意义

目的探讨细针穿刺细胞学与B超相结合对乳腺癌的诊断价值。方法采用B超引导下定位穿刺吸取细胞学及单纯应用针吸细胞学两种方法，与肿物切除后组织学检查相对比进行分析。结果肿物切除后组织学检查诊断乳腺癌98例，假阴性11例，其中36例应用B超引导下定位穿刺吸取细胞学检查，假阴性2例；62例单纯应用针吸细胞学检查，假阴性9例，细胞学诊断准确率分别为94．4％和85．5％，差异有显著性（P〈0．05）。结论细针穿刺细胞学检查具有安全、经济、方便、快速、痛苦小、准确率高的特点，结合B超引导下的定位穿刺更可获取足量的细胞成分，提高细胞学诊断正确率。对乳腺肿块尤其是对乳腺癌的筛选具有重要意义，可达到早期诊断和治疗目的。虽然乳腺的穿刺细胞学检查具有较高的可靠性，但仍存在一定的局限性和误诊率，需要组织学诊断解决。     

乳腺肿块细针针吸细胞学检测800例

 目的 探讨细针针吸细胞学（FNAC）对乳腺癌的诊断意义。方法 对800例乳腺肿块患者术前用7号针头一次性10 ml注射器进行细针穿刺涂片、染色、细胞学诊断，并与术后病理诊断进行比较，观察其准确率。结果 800例术前诊断乳腺癌563例，准确率达99.47 %。结论 FNAC检测方法安全、方便、经济，准确率高，可作为乳腺肿块常规检查手段     

乳腺肿块针吸细胞学诊断的可行性及假阴性分析

目的　减少对乳腺癌的漏诊 ,降低假阴性诊断 ,提高针吸细胞学诊断的准确性。方法　对 72 31例乳腺肿块进行针吸细胞学检查 ,获取病理组织学对照有 744例 ,计算其细胞学诊断的敏感性、特异性、假阳性率、假阴性率、诊断符合率。结果　本组针吸细胞学诊断敏感性为 93 6 7% ,特异性为 96 43 % ,假阳性率为 3 5 7% ,假阴性率为 6 33 % ,符合率为 94 0 9%。结论　针吸细胞学诊断的敏感性及特异性强 ,符合率高 ,是一种乳腺肿块重要的辅助诊断方法。肿瘤实质细胞较少或细胞异型性不明显是假阴性诊断的主要原因。注意触诊 ,重复针吸是减少假阴性的主要措施。     

327例乳腺肿块针吸细胞学与组织学检查对比分析

目的：探讨乳腺针吸细胞学检查(FNAC)对乳腺癌诊断的准确性。方法：对1062例乳腺肿块行FNAC检查，其中327例获得病理组织学对照。结果：本组针吸细胞学检查敏感性为97．3％，特异性为95．0％，潜在假阴性率2．7％，符合率95．4％。结论：(1)针吸细胞学是检查乳腺肿块的一种重要的辅助诊断方法，但仍存在一定的局限性。对疑难病例需要通过病理组织学确诊。(2)肿块实质细胞较少或细胞异形性不明显是阴性诊断的主要原因。穿刺前详细询问病史，进行大体检查，精确选择穿刺部位，穿刺时仔细体会针感及重复针吸是减少假阴性的主要手段。     

影像检查在乳腺肿块针吸细胞学诊断中的应用

目的:探讨钼靶摄片与B型超声波(B超)检查联合针吸细胞学检查诊断乳腺肿块的可靠性及对临床的指导意义.方法:选择有病理对照的104例乳房肿块患者,部分患者采用钼靶摄片及超声检查的影像学手段联合针吸细胞学,并将其结果与单一细胞学检查结果比较,评价钼靶摄片和超声检查与针吸细胞学联合检查的准确性.结果: 104例患者中联合钼靶摄片的细胞学诊断准确率为95.2%,联合超声检查的细胞学诊断准确率为90.9%,单一的细胞学诊断准确率为80%.假阳性未见.结论: 通过钼靶摄片及超声检查的影像学手段与细针穿刺细胞学联合诊断较为可靠,对术前诊断有一定的指导意义,但应结合实际情况选择合适的联合检查模式.     

乳腺肿块针吸细胞学诊断的可行性及假阴性分析

目的 减少对乳腺癌的漏诊,降低假阴性诊断,提高针吸细胞学诊断的 准确性,方法 对7231例乳腺肿块进行针吸细胞学检查,获取病理组织学对照有744例,计算其细胞学诊断的敏感性、特异性、假阳性率、假阴性率、诊断符合率。结果 本组针吸细胞学诊断敏感性为93.67%。特异性为96.43%,特异性为96.43%,假阳性率为3.57%,假阴性率为6.33%,符合率为94.09%。结论 针吸细胞学诊断的敏感性及特异性强,符合率高,是一种乳腺肿块重要的辅助诊断方法,肿瘤实质细胞较少或细胞异型性不明显是假阴性诊断的主要原因,注意触诊,重复针吸是减少假阴性的主要措施。     

乳腺肿块针吸细胞学检查157例报告

目的　探讨针吸细胞学在乳腺肿块中的诊断价值。方法　对本组中阳性、假阳性和未确定的细胞涂片进行了复查并与石蜡切片进行了对比分析。结果　 72例乳腺癌中 ,针吸细胞学诊断 6 1例 (84 7% )。 6例假阴性 (8 3 % ) ,85例良性病变通过针吸细胞学诊断 80例 (94% )。 2例假阳性 (2 4% )。 8例未明确定性 (5 1% )。结论　针吸细胞学检查是确诊乳腺肿块性质的有效方法。     

乳腺肿块针吸细胞学检查157例报告

目的 探讨针吸细胞学在乳腺肿块中的诊断价值。方法 对本组中阳性、假阳性和未确定的细胞涂片进行了复查并与石蜡切片进行了对比分析，结果 72例乳腺癌中，针吸细胞学诊断61例（84.7%)。6例假阴性（8.3%)，85例良性病变通过针吸细胞学诊断80例（94%），2例假阳性（2.4%)。8例未明确定性（5.1%)。结论 针吸细胞学检查是确诊乳腺肿块性质的有效方法。     

820例乳腺肿块针吸细胞学诊断分析

目的探讨我院乳腺肿块针吸细胞学诊断的准确率及误诊原因。方法分析820例乳腺肿块针吸细胞学检查结果,其中498例肿块切除后行组织学检查,比较针吸细胞学与病理组织学诊断结果。结果820例乳腺肿块中良性病变583例,恶性肿瘤237例,498例针吸细胞学与组织学诊断符合率为95.78%。结论乳腺肿块针吸细胞学诊断准确率高,能较准确地鉴别病变良恶性,对临床具有重要的指导意义。     

A case of mucinous carcinoma of the breast in which needle tract seeding was diagnosed by preoperative diagnostic imaging

Herein we report a 62-year-old woman with an excisable breast tumor in whom needle tract seeding was suspected during preoperative ultrasound and magnetic resonance imaging (MRI). A tumor of the right breast was observed during initial examination, and she was referred to our hospital after fine-needle aspiration cytology led to diagnosis of breast cancer, even though core needle biopsy results were negative. Mammography showed a high-density mass with a portion of the margin exhibiting very fine serrations. Ultrasonography revealed a circular mass with a border that was indistinct in some regions, and a hypoechoic band that extended from the tumor toward the skin. A mass was observed on MRI, with a linear enhancement extending on the skin side, and needle tract seeding was suspected. Fine-needle aspiration cytology revealed malignancy, and the histological appearance was consistent with mucinous carcinoma. T1cN0M0 stage I breast cancer was diagnosed, and wide excision and sentinel lymph node biopsy were performed. The skin directly above the tumor was concurrently excised to remove the biopsy puncture site. Histopathological diagnosis confirmed mucinous carcinoma, with the tumor observed to extend linearly into the subcutaneous adipose tissue in a pattern corresponding to the biopsy puncture site. The stump of the excised breast was negative for cancer cells. The possibility of tumor seeding must be considered during fine-needle aspiration cytology and biopsy. As demonstrated in this case, diagnosis of such seeding through preoperative imaging may enable extraction of the entire lesion, including the needle tract.     

乳腺癌前哨淋巴结活检术前临床可疑腋淋巴结超声引导针吸细胞学检测的临床意义

目的:评估腋淋巴结可疑阳性的乳腺癌患者,在前哨淋巴结活检术前行超声引导腋淋巴结针吸细胞学检测的临床意义。方法:回顾性分析了257 例超声提示腋淋巴结异常或腋淋巴结临床查体可触及的原发性乳腺癌患者的腋淋巴结针吸细胞学检测结果及常规病理结果。结果:超声引导腋淋巴结针吸细胞学检测乳腺癌可疑腋淋巴结的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为76.3% 、100% 、80.9% 、100% 和50.5% 。76.3% 的患者通过针吸细胞学检测准确地预测了腋淋巴结转移,避免了接受前哨淋巴结活检术。50.5% 的超声提示腋淋巴结异常但针吸细胞学阴性的患者可接受前哨淋巴结活检术替代腋淋巴结清扫术。结论:超声引导腋淋巴结穿刺针吸细胞学检测可快速、较为准确地判定乳腺癌患者腋淋巴结的状况,应该作为前哨淋巴结活检术前的筛查手段。      

Ultrasound-guided percutaneous fine-needle puncture cytology in the diagnosis of malignant tumors of the liver

Results of ultrasound guided percutaneous fine-needle puncture cytology in 142 cases of malignant tumors of the liver are reported. The positive cytology was noted in 118 (83.1%) (10 suspicious). The primary liver cancer comprised 99 cases. In 7 lesions, equal to or less than 3 cm in diameters, 6 were positive in cytology. In 20,3-5 cm in size, 18 were positive. In 15 false-negatives, 12 were larger than 5 cm in diameter. Among 43 cases of metastatic liver cancer, 34 showed positive cytology and 9 false-negative. Among 108 cases of benign hepatic diseases, in 49.1%, it was difficult to arrive at definitive diagnosis by ultrasonography only, but in 97.2% malignancy was excluded by ultrasound guided fine-needle puncture cytology. The suspicious false-positive result occurred only in 3 cases. In this series, there were 250 cases of malignant tumors and benign diseases. The overall accurate diagnostic rate was 89.2%. All the patients had been followed for more than 6 months. The differential diagnosis between malignant and benign tumors, causes of misdiagnosis and complications are discussed.     

Telomerase activity as a marker of breast carcinoma in fine-needle aspirated samples

BACKGROUND: Telomerase activity in breast fine-needle aspiration (FNA) samples may have diagnostic utility. The purpose of this study was to compare in FNA samples of breast tumor the diagnostic accuracy as correlated with histologic final diagnosis. METHODS: Fine-needle aspiration samples were obtained from 617 patients with palpable breast tumors. Slide preparation and cytology were performed according to a uniform approach. Extracts derived from 10(3) cells from the residual cells in the syringe were used for the telomeric repeat amplification protocol (TRAP) assay. Of the original 617 patients, 220 underwent open biopsy or surgery, and 93 cancers and 127 patients' benign diseases were diagnosed by histologic examination. RESULTS: All 62 tumors that were diagnosed as "malignant" or "probably malignant" by FNA cytology were cancerous, and 50 cases (81%) showed detectable telomerase activity. Among 17 "atypical" or "indeterminate" cases, all 10 tumors with detectable telomerase activity subsequently were diagnosed as breast carcinoma whereas 6 of 7 tumors without telomerase activity were diagnosed as benign. Among the 141 "benign" or "unsatisfactory" samples, 12 of 21 cases with detectable telomerase activity subsequently were diagnosed as cancer. CONCLUSIONS: The diagnostic accuracy of telomerase activity in FNA samples is considered to be equivalent or slightly higher to that of cytology (86% vs. 70%). Detection of telomerase activity should be considered an alert for false-negative results of FNA cytology and may be useful as a diagnostic marker for breast malignancy, especially in samples cytologically undetermined to be malignant. Cancer (Cancer Cytopathol) Copyright 2000 American Cancer Society.     

HER-2/neu amplification detected by fluorescence in situ hybridization in fine needle aspirates from primary breast cancer.

BACKGROUND: The HER-2/neu gene is amplified in 20-30% of human breast cancers and has been shown to have prognostic and predictive value for treatment with chemotherapy, hormone therapy and antibodies against the HER-2/neu domain (trastuzumab). The aim of our study was to evaluate the reliability of HER-2/neu determination by fluorescence in situ hybridization (FISH) on fine-needle aspirates (FNAs) from primary breast cancer patients by comparison with the results obtained by FISH and immunohistochemistry (IHC) on the corresponding histological sections. MATERIALS AND METHODS: HER-2/neu amplification was determined by FISH on 66 breast cancer FNAs. Twenty-three and 36 corresponding formalin-fixed, paraffin-embedded sections were assayed by FISH and by IHC, respectively, in order to detect HER-2/neu amplification and HER-2/neu protein expression. RESULTS: Twenty-seven per cent (18/66) of breast cancer FNAs showed amplification of HER-2/neu by FISH. Paired results by FISH cytology and FISH histology were available in 22 cases. Concordance was 91% (20/22). Paired results by FISH cytology and IHC were available in 36 cases. Concordance was 92% (33/36). Eighteen of 66 breast cancer FNAs were also submitted to flow cytometric DNA analysis. None of the diploid cases showed HER-2/neu amplification by FISH. Six out of the eight aneuploid cases were amplified and two were polysomic. CONCLUSIONS: HER-2/neu gene amplification can be reliably estimated by FISH on breast cancer FNAs and a good correlation has been found between FISH and IHC results from the corresponding histological sections.     

浅表淋巴结细针吸取细胞学检查的临床分析--附835例病例分析

目的：研究浅表淋巴结细针吸取细胞学检查在临床应用的价值.方法：对浅表可疑淋巴结行细针吸取细胞学检查并与临床诊断对照分析.结果：835例细胞学报告中以淋巴结增生或炎性病变及转移癌为主,转移癌的确诊率为98.74%;确诊为淋巴结增生及炎性病变的442例中,共有37例为恶性,假阴性率为8.77%.结论：细针吸取细胞学检查具有简单、安全、诊断符合率高等优点,可考虑作为相关疾病的常规诊断方法.     

Carcinome adénoïde kystique du sein

Adenoid cystic carcinoma of the breast is a rare neoplasm, accounting for only 0.1% of all malignant breast tumours. It is more common in women in the sixth decade of their lives and often in the subareolar area. The clinical criteria is not specific and the radiographic examination showed a benign-appearing tumour. The preoperative diagnosis is possible with fine-needle aspiration cytology. The diagnosis is made by histological examination, presented a difficult differential diagnosis with cribriform carcinoma; so it is necessary to use histochemical or immunohistochemical techniques. The treatment is not well established. It consists of lumpectomy with radiation or mastectomy. Compared to other locations, adenoid cystic carcinoma of the breast has a favorable prognosis. Lymph node involvement or distant metastases seldom occur. The aim of our study is to describe the epidemiological, clinicopathological characteristics, the treatment and the prognosis of this rare type of breast tumour.     

Clinical examination, mammographic findings and cytological diagnosis in patients with breast disorders. Results of 9 years' follow-up.

In January through March 1978, 482 consecutive patients sought advice and examination for different kinds of breast disorders at the Breast Unit of Radiumhemmet; 171 of them (32.8%) came without any prior known medical consultation. All patients were seen by a doctor and examined clinically; 385 underwent mammography and 196 fine-needle aspiration for cytology. Combined clinical and mammographic examination showed an estimated specificity with respect to 'breasts with no need of follow-up' of 77%. The corresponding sensitivity was 88%. Fine-needle aspirations showed an estimated specificity and sensitivity of 96% and 88% respectively. In the total material 26 malignant cases were found, of which 16 cancers were detected at the first examination. During a follow-up period of nine years, 10 additional breast cancers were found in the national cancer registry. This number could be compared to the expected number of 6.6 (SIR 1.52, 0.73-2.79) breast cancer cases if the studied women had had the same standardized incidence as the total female Swedish population. The mean number of visits to the Breast Unit was 1.6 for the 466 patients with benign disorders, of whom 322 had no need of follow-up. The mean follow-up time for these 482 patients was 113 days. During the follow-up time, 22 patients died. Ten patients, one of them with a breast cancer diagnosed, emigrated.     

Diagnostic reliability of combined physical examination, mammography, and fine-needle puncture ("triple-test") in breast tumors. A prospective study

A prospective study of 622 consecutively registered patients with 650 breast tumors was performed to appraise the reliability of combined physical examination, mammography, and fine-needle puncture (triple test) in the preoperative diagnosis of such tumors. All malignant as well as benign test results were confirmed by subsequent histologic examination. The diagnostic accuracy of the triple test at benign changes is comparable to that of histologic examination, but participation of experienced radiologists and cytologists as well as persons skilled in fine-needle puncture is required. Twenty-eight percent of the planned excisional biopsies were made superfluous by the fine-needle puncture, which immediately revealed the tumor as a cyst, abscess, or hematoma. For this reason, too, fine-needle puncture is recommended as a routine procedure.