乳腺肿物论文：乳腺肿物 微创 CNB 手术切除 活检

乳腺肿物论文：乳腺肿物 微创 CNB 手术切除 活检 【关键词】乳腺肿物 微创 CNB 手术切除 活检 【英文关键词】tumor VAB CNB OSB Biopsy 乳腺肿物论文:乳腺肿物微创旋切、空心针穿刺与手术切除活检的优劣比较与合理选择 【中文摘要】比较真空辅助微创旋切系统活检(vacuum-assisted biopsy,VAB)、空芯针穿刺活检(core needl biopsy,CNB)与开放式手术切除活检(open surgical biopsy, OSB)在乳腺肿物活检中三种活检方式的优缺点及对乳腺癌的后期治疗效果、并发症等方面的影响,旨在为乳腺肿物患者选择一种和适的活检方式提供临床参考依据。方法:选择2008年12月,2010年4月在广西医科大学附属肿瘤医院乳腺外科的337例乳腺肿物的患者作为临床研究对象,分成3组。分别行真空辅助微创旋切活检(VAB)114例、空芯针穿刺活检(CNB)120例,手术切除活检(0SB)103例。术后均行常规病理检查及免疫组织化学检查。并比较各组病人手术时间、费用、并发症、病理结果敏感性、假阴性率以及活检方式对远期复发的影响等。结果:术后微创(VAB)组114例患者中有1例未获得完整病理,2例皮下淤血;空芯针(CNB)组120例患者有8例未得到完整的病理结果,1例皮下淤血;切除(0SB)组103例患者中有4例患者因难以触及肿物,而改用其它方式 活检,余均取得了完整病理结果,1例皮下淤血。微创组手术切口长约 3mm,手术时间约5-15分钟,手术费用约4500元,CNB手术切口约2mm, 手术时间约5-20分钟,费用约700元,手术切除组,手术切口长约 15-40mm,手术时间20-50分钟,费用约300元。结论:微创旋切术、 空芯针穿刺术及传统开放式肿物切除活检术各有优势,微创旋切术对 一侧乳房多个肿物切除,对较小、较深、难触及肿物切除(切检)以及 中晚期乳腺癌新辅助化疗前的活检病理分型的病人最具优势,最有发 展优势。CNB费用低廉,同样有利于肿物早期活检。但是组织量少,病 理结果假阴性率相对高,易漏诊、诊断不足。开放性肿物切除活检手 术在病理获得方面最具准确性,仍有不可替代的优势。缺点是损伤较 大,对较小肿物及位置较深触及不明显病灶难以切除。 【英文摘要】PURPOSE:Through compare the effects about vacuum-assisted biopsy (VAB)、core needl biopsy (CNB) and Open surgery excision biopsy (OSB)In breast tumor biopsy. and provide a basis for procedure selection of appropriate method for breast tumor biopsy.Methods:The337patients considered for tumor patients were selected as clinical research subjects, they had been treated in Guangxi Medical University Affiliated Tumor Hospital breast center during2008.12. to2010.4.. these patients were divided into three groups, were respectively given the vacuum-assisted biopsy (VAB)114cases、CNB120cases and Open surgery excision biopsy103cases, postoperative underwent routine pathological examination and immunohistochemical examination. A analysis and comparison of the groups of patients about operation time, complications, sensitivety of pathological findings, the false negative rate and the relation in biopsy method and forward recurrence was given, et al.Results:It is respectively1case,8cases and4cases that did not got complete pathologic results in vacuum-assisted biopsy (VAB) group,CNB group and resection group postoperative. and the subcutaneous hemorrhage of the thing is respectively2cases, lcase and lcase.Group VAB operation incision length is3mm, operation time is5to15 minutes, operation cost is around,4500; the case in the group CNB that is respectively2mm,5to20minutes and,700; it is respectively15to40mm20to50minutes and,300in the resection group.Conclusion:vacuum-assisted biopsy (VAB)、CNB and open surgery excision biopsy has an advantage each. VAB and CNB have the most advantage on the side of breast multiple tumor resection and difficult to reach tumor resection (biopsy), the weakness of the VAB is that Patients need to spend a lot of money. CNB is low cost, but it gained organization quantity is little, histopathologic findings of the false negative rate is high, easy misdiagnosis, inadequate diagnosis. The excision biopsy operation is most accuracy in terms of obtaining pathological aspects. there is still irreplaceable advantages. Drawback is that too much damage, the smaller tumors are difficult to resect. 【目录】乳腺肿物微创旋切、空心针穿刺与手术切除活检方法的 优劣比较与合理选择 摘要 4-6 ABSTRACT 6-7 前言 8-10 资料与方法 10-14 结果 14-23 讨论 23-28 结论 28-29 附录 29-30 参考文献 30-33 综述 33-41 参考文献 39-41 致谢 41