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目的分析和总结粗针穿刺活检(NCB)乳腺癌的病理诊断。方法复习219例乳腺NCB切片,并进行分类、分型和分级。部分诊断困难病例选用SMA、p63、CD10、CK5/6、34βE12、ER、E-cadherin和p120鉴别。32例有手术切除标本者进行了手术前后病理诊断对照。结果良性病变127例,包括:普通型导管增生21例,腺病52例,纤维腺瘤30例,乳头状瘤9例,非典型导管增生4例,炎症10例,脂肪坏死1例。乳腺癌90例,其中非特殊类型浸润性导管癌71例,浸润性小叶癌8例,黏液癌4例,小管癌1例,神经内分泌癌1例,导管原位癌5例。1例良、恶性不能肯定;1例未见乳腺导管和小叶结构。在85例浸润性乳腺癌中能够进行组织学分级者49例(57.6%)。11/12例良性病变(91.7%)和19/19例(100%)癌NCB与手术标本病理诊断一致。结论绝大部分乳腺病变NCB能够获得正确的病理诊断。硬化性腺病、非典型导管增生、乳头状肿瘤、小叶肿瘤/癌和导管原位癌需要免疫组化鉴别,并且部分病例需要给临床提供不肯定诊断信息。
Objective To analyze and summarize the pathological diagnosis of breast cancer by needle biopsy (NCB). Methods 219 cases of breast NCB were reviewed and classified, classified and graded. Some cases of difficult diagnosis of SMA, p63, CD10, CK5 / 6,34βE12, ER, E-cadherin and p120 identification. 32 cases of patients with surgical resection of the pathological diagnosis before and after surgery control. Results There were 127 cases of benign lesions, including 21 cases of common ductal hyperplasia, 52 cases of adenosis, 30 cases of fibroadenoma, 9 cases of papilloma, 4 cases of atypical ductal hyperplasia, 10 cases of inflammation and 1 case of fat necrosis. There were 90 cases of breast cancer, including 71 cases of non-specific type of invasive ductal carcinoma, 8 cases of invasive lobular carcinoma, 4 cases of mucinous carcinoma, 1 case of small duct carcinoma, 1 case of neuroendocrine carcinoma and 5 cases of ductal carcinoma in situ. One case of benign and malignant can not be sure; one case did not have ductal and lobular structures. Forty-nine cases (57.6%) were histologically able to differentiate in 85 invasive breast cancers. 11/12 benign lesions (91.7%) and 19/19 (100%) cancerous NCBs were consistent with the pathological findings of the surgical specimens. Conclusion Most breast lesions NCB can get the correct pathological diagnosis. Sclerodendenosis, atypical ductal hyperplasia, papillary tumors, lobular tumors / carcinoma and ductal carcinoma in situ require immunohistochemical identification, and in some cases, clinical uncertainty information needs to be provided.