138例乳头溢液病例的临床特征分析
|
摘要
目的对乳头溢液病例的临床特征进行回顾性分析,探讨年龄、乳头溢液的性状、是否合并乳房肿块等因素与乳头溢液病理诊断的关系,为合理制订临床治疗方案提供参考。方法回顾性分析2013年1月至2018年7月在首都医科大学附属北京天坛医院乳腺科住院治疗的138例乳头溢液患者的临床资料。分析患者年龄、乳头溢液的性状、是否合并乳房肿块等因素与乳头溢液性疾病的病理诊断间的关系。结果统计分析显示年龄>50岁者病变为恶性的例数(10例)高于年龄≤50岁者(1例),差异有显著性(P=0.000)。乳头血性溢液患者病变为恶性的例数(9例)高于浆液性(1例)及清水样(1例)溢液的患者,差异有显著性(P=0.000)。影像学检查有阳性发现的乳头溢液患者病变为恶性的例数(8例)高于影像学检查阴性(3例)的患者,差异有显著性(P=0.037)。结论患者年龄、乳头溢液的性状、是否合并乳房肿块对鉴别乳头溢液的良恶性具有重要意义。
Objective Through retrospective analysis of the clinical features of nipple discharge, to discuss the relationship between the age of the patient, the character of nipple discharge, and whether the breast lump was concomitant with the pathological diagnosis, providing a reference basis for more reasonable clinical treatment plans. Method Retrospectively analyzed the clinical data of 138 cases of nipple discharge that were hospitalized in the Breast Department from January 2013 to July 2018 in Beijing Tiantan Hospital, Capital Medical University. The relationship between the age of the patient, the character of nipple discharge, whether the breast lump was concomitant with the pathologic diagnosis of nipple discharge was analyzed. Result Statistical analysis suggested that patients with nipple discharge at the age of more than 50 years old were more likely to have malignant lesions than patients less than or equal to 50 years old(P=0.000).Patients with papillary hemorrhagic effusion were more likely to have malignant lesions than those with serous and clear effusion(P=0.000). Patients with nipple discharge detected by positive imaging findings were more likely to have malignant lesions than patients with negative imaging findings(P=0.037). Conclusion The age of the patient, the character of nipple discharge, and whether the breast lump is concomitant have important clinical significance to distinguish the benign and malignant nipple discharge.
Objective Through retrospective analysis of the clinical features of nipple discharge, to discuss the relationship between the age of the patient, the character of nipple discharge, and whether the breast lump was concomitant with the pathological diagnosis, providing a reference basis for more reasonable clinical treatment plans. Method Retrospectively analyzed the clinical data of 138 cases of nipple discharge that were hospitalized in the Breast Department from January 2013 to July 2018 in Beijing Tiantan Hospital, Capital Medical University. The relationship between the age of the patient, the character of nipple discharge, whether the breast lump was concomitant with the pathologic diagnosis of nipple discharge was analyzed. Result Statistical analysis suggested that patients with nipple discharge at the age of more than 50 years old were more likely to have malignant lesions than patients less than or equal to 50 years old(P=0.000).Patients with papillary hemorrhagic effusion were more likely to have malignant lesions than those with serous and clear effusion(P=0.000). Patients with nipple discharge detected by positive imaging findings were more likely to have malignant lesions than patients with negative imaging findings(P=0.037). Conclusion The age of the patient, the character of nipple discharge, and whether the breast lump is concomitant have important clinical significance to distinguish the benign and malignant nipple discharge.
引文
[1]邵志敏,沈镇宙,徐兵河.乳腺肿瘤学[M].上海:复旦大学出版社,2013:194-198.
[2]Sakorafas GH.Nipple discharge:current diagnostic and therapeutic-capprouches[J].Cancertreat Rev,2001,27(5):275-282.
[3]吴新五,刘继锁,左文述,等.56例乳头溢液病例的临床病理分析[J].肿瘤防治杂志,2002,9(3):287.
[4]周伟杰,宋爱莉,朱建敏.乳头溢液的病因及诊断[J].医学理论与实践,2005,18(5):497.
[5]张强,张斌,李爽.良恶性乳腺疾病乳头溢液的临床表现(附265例多因素分析)[J].中国实用外科杂志,2005,25(2):81.
[6]Hunerbein M,Estevez SL,Schneider U,et al.Evaluation of pathologic nipple discharge with ductoscopy[J].J Am Coll Surg,2003,197(4):697-699.
[7]韩晓蓉,王颀,连臻强,等.乳腺导管内乳头状瘤663例临床及诊断特点[J].岭南现代临床外科,2013,13(4):304-307.
[8]胡永升.现代乳腺影像诊断学[M].北京:科学出版社,2001:83-87.
[9]Wang W,Ding J,Yang W,et al.MRI characteristics of intraductal papilloma[J].Acta Radiol,2015,56(3):276-283.
[10]Eiada R,Chong J,Kulkarni S,et al.Papillary lesions of the breast:MRI,ultrasound,and mammographic appearances[J].AJR Am JRoentgenol,2012,198(2):264-271.
[11]王克有,蒋宏传,游凯涛.乳管镜检查在乳头溢液中的地位[J].中国微创外科杂志,2001,1(4):243-244.
[12]Richter-Ehrenstein C,Tombokan F,Fallenberg EM,et al.Intraductal papillomas of the breast:diagnosis and management of151 patients[J].Breast,2011,20(6):501-504.
[13]Yang Y,Suzuki K,Abe E,et al.The significance of combined CK5/6 and p63 immunohistochemistry in predicting the risks of subsequent carcinoma development in intraductal papilloma of the breast[J].Pathol Int,2015,65(2):81-88.
[14]马榕,吴土金.乳头溢液的诊断及对策[J].中国实用外科杂志,2016,36(7):738-741.
[15]姜军,贺青卿.乳头溢液的病因及鉴别诊断[J].中国实用外科杂志,2005,25(2):71.
[16]Zhang K,Zhao S,Wang Q,et al.Identification of microRNAs in nipple discharge as potential diagnostic biomarkers for breast cancer[J].Ann Surg Oncol,2015,22 Suppl 3:S536-S544.
[2]Sakorafas GH.Nipple discharge:current diagnostic and therapeutic-capprouches[J].Cancertreat Rev,2001,27(5):275-282.
[3]吴新五,刘继锁,左文述,等.56例乳头溢液病例的临床病理分析[J].肿瘤防治杂志,2002,9(3):287.
[4]周伟杰,宋爱莉,朱建敏.乳头溢液的病因及诊断[J].医学理论与实践,2005,18(5):497.
[5]张强,张斌,李爽.良恶性乳腺疾病乳头溢液的临床表现(附265例多因素分析)[J].中国实用外科杂志,2005,25(2):81.
[6]Hunerbein M,Estevez SL,Schneider U,et al.Evaluation of pathologic nipple discharge with ductoscopy[J].J Am Coll Surg,2003,197(4):697-699.
[7]韩晓蓉,王颀,连臻强,等.乳腺导管内乳头状瘤663例临床及诊断特点[J].岭南现代临床外科,2013,13(4):304-307.
[8]胡永升.现代乳腺影像诊断学[M].北京:科学出版社,2001:83-87.
[9]Wang W,Ding J,Yang W,et al.MRI characteristics of intraductal papilloma[J].Acta Radiol,2015,56(3):276-283.
[10]Eiada R,Chong J,Kulkarni S,et al.Papillary lesions of the breast:MRI,ultrasound,and mammographic appearances[J].AJR Am JRoentgenol,2012,198(2):264-271.
[11]王克有,蒋宏传,游凯涛.乳管镜检查在乳头溢液中的地位[J].中国微创外科杂志,2001,1(4):243-244.
[12]Richter-Ehrenstein C,Tombokan F,Fallenberg EM,et al.Intraductal papillomas of the breast:diagnosis and management of151 patients[J].Breast,2011,20(6):501-504.
[13]Yang Y,Suzuki K,Abe E,et al.The significance of combined CK5/6 and p63 immunohistochemistry in predicting the risks of subsequent carcinoma development in intraductal papilloma of the breast[J].Pathol Int,2015,65(2):81-88.
[14]马榕,吴土金.乳头溢液的诊断及对策[J].中国实用外科杂志,2016,36(7):738-741.
[15]姜军,贺青卿.乳头溢液的病因及鉴别诊断[J].中国实用外科杂志,2005,25(2):71.
[16]Zhang K,Zhao S,Wang Q,et al.Identification of microRNAs in nipple discharge as potential diagnostic biomarkers for breast cancer[J].Ann Surg Oncol,2015,22 Suppl 3:S536-S544.