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首页> 外文期刊>Surgical Endoscopy >Breast duct microendoscopy in nipple discharge: microbrush improves cytology.
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Breast duct microendoscopy in nipple discharge: microbrush improves cytology.

机译：乳头溢液的乳腺导管内窥镜检查：微刷可改善细胞学。

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BACKGROUND: Breast duct microendoscopy is a new technique that allows direct visualization of the mammary ductal epithelia and has the potential to provide greater accuracy in the diagnosis of benign and malignant breast conditions. We have already established the feasibility of BDME on mastectomy specimens and in patients both under general and local anesthesia. It was the aim of this study to investigate the use of BDME in patients with pathological nipple discharge and to explore the feasibility of using an endoluminal microbrush to take cytology samples from specific lesions. MATERIALS AND METHODS: Breast duct microendoscopy was offered to all patients undergoing surgery for nipple discharge. Surgery included microdochectomy (younger women) and total duct excision (especially in postmenopausal women). The microbrush was used to collect samples whenever an endoluminal papilloma was seen on endoscopy. The results of microbrush cytology samples were compared to ductal lavage samples. RESULTS: Fifty consecutive patients undergoing microdochectomy or total duct excision for nipple discharge had breast microendoscopy (28 general, and 22 under local anesthesia). Thirty-one patients had microdochectomy and nineteen had total duct excision. Visualiza- tion of discharging ducts was accomplished in 100% cases. Endoluminal abnormalities were seen in 33 (66%) patients and dilated ducts were seen in 17 patients. Among the 33 patients, 15 had single papilloma, 3 multiple papilloma and 15 inflammation (erythema, fronds, adhesions). Seven out of eight patients with an intraductal papillorna who had microbrush cytology showed papillary cells whereas only 2 out of 11 patients who had ductal lavage were positive for papillary cells. Thus the sensitivity of the brush cytology technique for the diagnosis of papilloma was 87.5% and the sensitivity of ductal lavage 18% (p = 0.0055). CONCLUSION: Breast duct microendoscopy is an effective way of establishing the etiology of nipple discharge. The microbrush increases the sensitivity of cytology significantly.
机译：背景：乳腺导管内窥镜检查是一项新技术，可以直接可视化乳腺导管上皮，并有可能在诊断乳腺良恶性疾病中提供更高的准确性。我们已经确定了BDME在乳房切除术标本上以及在全身麻醉和局部麻醉下的患者的可行性。这项研究的目的是调查BDME在病理性乳头溢液患者中的使用，并探讨使用腔内微刷从特定病变中获取细胞学样本的可行性。材料与方法：为所有因乳头溢液而接受手术的患者提供了乳腺导管内窥镜检查。手术包括微腔切除术（年轻女性）和全导管切除术（尤其是绝经后女性）。只要在内窥镜检查中发现腔内乳头状瘤，就用微刷收集样品。将微刷细胞学样本的结果与导管灌洗样本进行比较。结果：连续进行了50例行乳头内窥镜切除术或全乳管切除术的患者进行了乳房微内窥镜检查（28例，局部麻醉下22例）。 31例患者行微十二指肠切除术，十九例患者行全导管切除术。排放管道的可视化在100％的情况下完成。 33例（66％）患者可见腔内异常，17例患者可见导管扩张。在33例患者中，有15例患有单发乳头状瘤，3例患有多发性乳头状瘤和15例炎症（红斑，叶状体，粘连）。微刷细胞学检查的八名导管内乳头状瘤患者中有七名显示乳头状细胞，而导管灌洗的十一名患者中只有二分之二为乳头状细胞阳性。因此，刷式细胞学技术诊断乳头状瘤的敏感性为87.5％，导管灌洗的敏感性为18％（p = 0.0055）。结论：乳管显微内窥镜检查是建立乳头溢液病因的有效方法。微刷显着提高了细胞学敏感性。

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