摘要
目的 研究乳管镜在诊断伴乳头溢液的乳管内增生性病变方面的临床应用价值。
方法 收集2001年10月至2004年1月以乳头溢液为主要症状的患者34例，患者全部经纤维乳管镜（Fiberoptic ductoscopy，FDS）检查与术后病理检查，纤维乳管镜的检查结果全部为乳管内增生性病变，包括乳管内乳头状瘤和乳管内癌。FDS的检查结果与病理检查结果相对照。
结果 34例患者中FDS的检查结果为乳管内乳头状瘤25例，乳管内癌为9例；病理检查结果提示：在FDS诊断的25例乳头状瘤中，有23例被病理结果证实，在FDS诊断的9例乳管内癌中，有8例被病理结果证实。FDS的乳管内乳头状瘤的诊断符合率为92%（23∕25），诊断乳管内癌的符合率为88.9%（8∕9），增生性病变总的符合率为91.2%（31∕34）。
结论 乳管镜对伴有乳头溢液的乳管内增生性病变具有较高的诊断价值，优于乳腺X线摄影、超声及细胞学检查等，可以提高乳腺癌的早期诊断率，检查完毕后患者无疼痛及乳管内继发感染，可以作为乳头溢液的患者的常规检查。
Objective To evaluate the value of Fiberoptic Ductoscopy’s (FDS)clinical diagnosis in the patients of breast intraductal hyperplastic diseases with nipple discharge.
Methods We had collected 34 patients with nipple discharge from Oct. 2001 to Jan. 2004. FDS was used on all patients that were identified the breast intraductal hyperplastic disease (breast intraductal papilloma and intraductal carcinoma) by FDS. All the specimens were accepted the pathological examination after operation. The results of FDS were compared with the results of pathological examination.
Results FDS was successful in visualizing the intraductal lesion in all 34 patients, detected papillomas in 25 patients and intraductal carcinoma in 9 patients. 23 papillomas of 25 patients were verified by pathological examination. 8 of 9 patients were verified intraductal carcinoma by pathological examination. The diagnostic rate of intraductal papilloma by FDS was 92﹪(23∕25), diagnostic rate of intraductal carcinoma by FDS was 88.9﹪(8∕9), diagnostic rate of breast intraductal hyperplastic disease by FDS was 91.2﹪(31∕34) .
Conclusions FDS examination has an advantage over the breast X-ray photography, ultrasonography and cytology. It is very valuable in the diagnosis of breast intraductal hyperplastic disease, and can enhance the early diagnostic rate of breast cancer. After FDS examination, all the patients had no pain and intraductal subsequent infection, so it can be used as a routine examination of patient with nipple discharge.
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