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目的探讨乳管镜联合美蓝染色定位导管内病变的方法对病理性乳头溢液患者导管内微小病变的诊断价值。方法对湖北省妇幼保健院2007年1月-2013年12月收治的842例病理性乳头溢液患者乳管镜检查后,病变导管内即刻注射美蓝染色定位,行病变导管及区段切除,观察其治疗效果和随访结果。结果该方法中乳管镜检查总符合率为71.26%,导管内微小病变的诊断率为76.13%,乳腺癌的诊断率为9.74%,乳腺癌在导管内微小病变中的比例为12.79%。随访的729例患者中,乳腺癌患者(82例)均无病生存,高危因素患者(127例)无新发乳腺癌,良性病变患者(520例)中1例非手术部位患乳腺癌。结论乳管镜检查联合美蓝导管染色定位法可提高乳腺导管内微小病变中早期乳腺癌的诊断率,为病理性乳头溢液患者开展大规模乳腺癌筛查及乳腺癌的预防提供了一定指导意义。
Objective To investigate the diagnostic value of ductal mirror combined with methylene blue staining in the localization of intraductal lesions in patients with pathological nipple discharge. Methods Eighty-four patients with pathological nipple discharge who were admitted to Hubei MCH from January 2007 to December 2013 were examined with methylene blue stain immediately after the catheterization, and the lesion was removed. Observe the treatment effect and follow-up results. Results The total coincidence rate of ductoscopy in this method was 71.26%. The diagnostic rate of intraductal minor lesions was 76.13%. The diagnostic rate of breast cancer was 9.74%. The proportion of breast cancer in intraductal minor lesions was 12.79%. Of the 729 patients who were followed up, 82 patients with breast cancer were disease-free and 127 patients with no risk of breast cancer. Of the 520 patients with benign disease, one patient had breast cancer at a non-surgical site. Conclusion Ductoscopy combined with methylene blue staining can improve the diagnostic rate of early breast cancer in minimal intraductal lesions and provide some guidance for large-scale breast cancer screening and breast cancer prevention in patients with pathological papillary discharge significance.