国际医学放射学杂志2025，Vol.48Issue(4)：391-396,6.DOI:10.19300/j.2025.L22085
超声引导下空芯针穿刺活检诊断的单纯型乳腺导管内乳头状瘤:术后升级为恶性的预测因素
Breast pure intraductal papilloma on US-guided core-needle biopsy:potential predictors of upgrading to malignancy
摘要
Abstract
Objective To determine the postoperative upgrade rate of pure intraductal papilloma(IDP)diagnosed by ultrasound-guided core needle biopsy(CNB)and identify potential predictors of malignant upgrade,aiming to improve diagnostic accuracy and optimize clinical decision-making.Methods This retrospective study included 114 female patients with pathologically confirmed pure IDP via ultrasound-guided CNB,with a mean age of 45.8±9.3 years and 114 lesions.Based on postoperative pathology,the patients were divided into a benign group(n=108)and a malignant group(n=6).Among them,78 patients underwent additional ultrasound-guided fine-needle aspiration(US-FNA)and were similarly categorized into a benign group(n=73)and a malignant group(n=5)based on surgical pathology.Welch's t-test and Fisher's exact test were used to compare clinical,imaging,and pathological characteristics between benign and malignant groups.Univariate logistic regression analysis was performed.Characteristics showing statistically significant differences in the group comparisons and univariate Logistic regression were further analyzed using multivariate Logistic regression to identify independent predictors of postoperative malignant upgrade.Results Among the 114 pure IDP cases,six(5.3％)were upgraded to malignant postoperatively.Group comparisons and univariate logistic regression analysis showed statistically significant differences between benign and malignant groups in patient age,US-FNA,maximum lesion diameter,presence of microcalcifications,ultrasound BI-RADS category,and ultrasound-pathology concordance,with all these factors showing some correlation with malignant upgrade (P<0.05 for all). Multivariate Logistic regression analysis identified the presence of microcalcifications (OR=9.068,P=0.044) and the detection of atypical/malignant/suspicious cells on US-FNA (OR=19.956,P=0.036) as independent predictors of postoperative malignant upgrade. Conclusion Microcalcifications observed on ultrasound,and presence of atypical,suspicious malignant,or malignant/cells detected by FNA are high-risk factors for malignant upgrade of IDP. Ultrasound-guided FNA can effectively reduce the false-negative rate of CNB,improve diagnostic accuracy for IDP,and assist in clinical decision-making.关键词
超声引导空芯针活检/乳腺/导管内乳头状瘤/细针抽吸活检Key words
Ultrasound-guided core-needle biopsy/Breast/Intraductal papilloma/Fine needle aspiration分类
医药卫生引用本文复制引用
王博,王吴婉,雷慧仔,崔立刚,王勇..超声引导下空芯针穿刺活检诊断的单纯型乳腺导管内乳头状瘤:术后升级为恶性的预测因素[J].国际医学放射学杂志,2025,48(4):391-396,6.基金项目
国家自然科学基金面上项目(82472000) （82472000）
首都卫生发展科研专项(首发2024-2-40210) （首发2024-2-40210）
