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首页> 外文期刊>Journal of Surgical Oncology >The diagnostic value of nipple discharge cytology: Breast imaging complements predictive value of nipple discharge cytology
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The diagnostic value of nipple discharge cytology: Breast imaging complements predictive value of nipple discharge cytology

机译：乳头溢液细胞学的诊断价值：乳腺成像可补充乳头溢液细胞学的预测价值

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Background Papilloma is the most common finding associated with pathologic nipple discharge. In the absence of breast imaging abnormalities, the incidence of occult malignancy is <3%. Objective To determine the predictive value of nipple discharge cytology in conjunction with breast imaging. Methods Retrospective review of 160 charts; inclusion criteria of clinically pathologic nipple discharge, subsequent excisional biopsy, and absence of palpable abnormalities. Nipple discharge cytology categorized as negative, atypical, suspicious, and papillary. Breast imaging was analyzed. Preoperative tests were correlated to final surgical pathology. Results 89 patients identified. Sixty-five had positive cytology, with a false positive rate of 32.3%. They were associated with papillomas in 52%, benign non-papillary in 33% and malignant lesions in 9% of cases. Nipple discharge cytology was positive in 69.6% of papillomas and 92% of atypical/malignant lesions; 30% had abnormal breast imaging and positive cytology. Nipple discharge cytology had a sensitivity of 74.5%, specificity of 30%, and positive predictive value of 68%. The positive predictive value increased to 85% with associated abnormal breast imaging. Conclusions Nipple discharge cytology is useful in evaluating pathologic discharge. However, negative cytology with negative imaging is not enough to avoid surgery in cases of suspicious clinical presentation. J. Surg. Oncol. 2012; 106:381-385.
机译：背景乳头状瘤是与病理性乳头溢液相关的最常见发现。在没有乳房成像异常的情况下，隐匿性恶性肿瘤的发生率＜3％。目的结合乳腺影像学检查确定乳头溢液细胞学的预测价值。方法回顾性分析160张图表;临床病理性乳头溢液，随后的切除活检和无明显异常的纳入标准。乳头溢液细胞学分为阴性，非典型，可疑和乳头状。乳房成像进行了分析。术前检查与最终手术病理相关。结果确定了89例患者。 65例细胞学阳性，假阳性率为32.3％。他们与乳头状瘤相关的占52％，良性非乳头状的占33％，恶性病变的占9％。乳头状瘤和非典型/恶性病变的乳头状瘤细胞学阳性率分别为69.6％和92％; 30％的乳房影像学异常且细胞学检查阳性。乳头溢液细胞学检查的敏感性为74.5％，特异性为30％，阳性预测值为68％。伴有异常乳房影像学检查的阳性预测值增至85％。结论乳头溢液的细胞学检查有助于评估病理性溢液。然而，在可疑的临床表现中，阴性的细胞学检查不足以避免手术。 J. Surg。 Oncol。 2012; 106：381-385。

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