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題名:細針抽吸細胞學檢查在乳房腫瘤篩檢的角色:以某地區醫院的經驗評估其價值
書刊名:健康管理學刊
作者:張保欽徐均宏白瑞聰
作者(外文):Chang, Bao-chiienHsu, Chun-hungPai, Jei-tsung
出版日期:2014
卷期:12:1
頁次:頁61-68
主題關鍵詞:細針抽吸細胞學乳癌三面式評估Breast cancerFine needle aspiration cytologyTriple assessment
原始連結:連回原系統網址new window
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本文主要為回溯性研究,蒐集2004年1月至2012年12月至本研究醫院外科接受乳房細針抽吸細胞學(Fine Needle Aspiration Cytology,以下簡稱FNAC)檢查病患,共有265人次,其年齡分布,從17歲到99歲,平均年齡51.06歲。265人次中有69人次(平均年齡50.26歲)接受進一步切片確定診斷與治療,執行率為26%。本研究醫院之FNAC診斷正確率為85.7%;無偽陽性(C4+C5偽陽性=0);FNAC報告C2(良性)之偽陰性較高(佔27.2%);FNAC報告C3(非典型)之惡性率佔13.6%,良性率佔32.3%;FNAC報告C2仍以良性疾病之比例較高。FNAC對乳癌篩檢的角色一直被公認為最簡便、最經濟、最迅速、安全的方法,雖然一直有更進步的診斷工具,然而強調只要有經驗豐富的三面式評估團隊,尤其是外科醫師臨床細針抽吸的技術與抹片技巧、放射學的診斷(包括超音波或乳房攝影)專業、以及細胞診斷經驗豐富的病理醫師,FNAC仍然可為快速正確篩檢或診斷乳癌的工具。另外,本文對FNAC之興衰過程及優缺點做進一步文獻回顧,並展望未來有更精緻的應用。
There were 265 visitors receiving fine needle aspiration cytology (FNAC) of the breast in our OPD from January 2004 to December 2012. We used our Laboratory Information System (LIS) to collect the data of FNAC, and checked their following histology. They were age from 17 to 99 years old with mean 51.06. Only 69 visitors received a further biopsy or excisional histologic confirmation. Our FNAC accurate diagnostic rate was 85.7%, and without false positive in C4nor C5. However, the false negative rate was 27.2% in C2. To our knowledge, FNAC is a good method for screening breast cancer, even if some more accurate methods have been used today, and the sensitivity and accurate diagnostic rate of FNAC is dependent on the triple assessment and their expert experiences. We also reviewed the literature about FNAC and their further application in future.
期刊論文
1.Ariga, R.、Bloom, K.、Reddy, V. B.、Kluskens, L.、Francescatti, D.、Dowlat, K.、Gattuso, P.(2002)。Fine-needle Aspiration of Clinically Suspicious Palpable Breast Masses with Histopathologic Correlation。Am J Surg,184(5),401-403。  new window
2.Berner, A.、Sauer, T.(2011)。Fine-needle Aspiration Cytology of the Breast。Ultrastruct Pathol,35,162-167。  new window
3.Chaiwun, B.、Settakorn, J.、Ya-In, C.、Wisedmongkol, W.、Rangdaeng, S.、Thorner, P.(2002)。Effectiveness of Fine-needle Aspiration Cytology of Breast: Analysis of 2,375 Cases from Northern Thailand。Diagn Cytology,26(3),201-205。  new window
4.Clark, D. P.(2009)。Seize the Opportunity。Cancer cytopathol,25,289-297。  new window
5.Gilchrist, A. M.(2002)。Comment on: Should Fine Needle Aspiration Cytology (FNAC) in Breast Assessment be Abandoned?。ClinRadiol,57,863。  new window
6.Lamb, J.、Anderson, T. J.、Dixon, M. J.、Levack, P. A.(1987)。Role of Fine Needle Aspiration Cytology in Breast Cancer Screening。J ClinPathol,40,705-709。  new window
7.Litherland, J. C.(2002)。Should Fine Needle Aspiration Cytology in Breast Assessment be Abandoned?。Clinical Radiology,57,81-84。  new window
8.Smith, M. J.、Heffron, C. C.、Rothwell, J. R.、Loftus, B. M.、Jeffers, M.、Geraghty, J. G.(2012)。Fine Needle Aspiration Cytology in Symptomatic Breast Lesion: Still an Important Diagnostic Modality?。The Breast Journal,18,103-110。  new window
9.Steinberg, J. L.、Trudeau, M. E.、Ryder, D. E.、Fishell, E.、Chapman, J. A.、McCready, D. R.、Lickley, L. A.(1996)。Combined Fine-needle Aspiration, Physical Examination and Mammography in the Diagnosis of Palpable Breast Masses: Their Relation to Outcome for Women with Primary Breast Cancer。Can. J. Surg,39(4),302-311。  new window
10.Wells, C. A.、Perera, R.、White, F. E.、Domizio, P.(1999)。Fine Needle Aspiration Cytology in the UK BreastScreening Programme: A National Audit of Results。The Breast,8,261-206。  new window
11.Zajdela, A.、Ghossein, N. A.、Pilleron, J. P.、Ennuyer, A.(1975)。The Value of Aspiration Cytology in the Diagnosis of Breast Cancer: Experience at the Curie Foundation。Cancer,35,499-506。  new window
其他
1.National Breast Cancer Centre(2004)。Breast fine needle aspiration cytology and core biopsy: a guide for practice,http://canceraustralia.gov.au/publications-resources/cancer-australia-publications/breast-fine-needle-aspiration-cytology-and-core, 2012/11/21。  new window
 
 
 
 
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