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乳腺结构不良症囊性增生期诊疗探讨 附76例报告

王钟富 俞仁雯 王珏

【摘 要】 目的 探讨乳腺结构不良症囊性增生期的临床诊断标准及治疗原则。方法 回顾性分析76例囊肿增生病例。结果 76例中,有8例重度不典型增生,6例乳头状瘤样增生,4例腺管型腺病,其它仅上皮增生。1例腺瘤样增生肿块切除,10年后有恶变现象。结论 乳腺结构不良症的囊性增生期,临床诊断标准关键在于发病年龄为40岁左右及无规律性乳痛,一侧肿块,组织学为导管上皮不典型增生为特点而决定诊治原则。为防止恶变及恶性病变漏诊,肿块切除后必须作常规病理检查。
【关键词】 乳腺结构不良症 乳腺囊性增生

Investigation in diagnosis and therapy on cystic hyperplasia of mammary dysplasia:a report of 76 cases

Wang Zhongfu
(Department of Surgery The first Affiliated Hospital of Henan Medical University,Zhengzhou 450052)
Yu Renwen,Wang Jue.

【Abstract】 Objecitve To study the principle of clinical diagnosis and therapy of cystic hyperplasia of mammary dysplasia.Methods Among 196 patients suffering from mammary dysplasia collected from 1986 to 1996 in Department of Surgery,The First Teaching Hospital of Henan Medical University,totally 76 cases were diagnosed as cystic hyperplasia of mammary dysplasia.A retrospective analysis of clinical characteristics and therapeutic methods was evaluated.Results Among 76 cases there were 8 cases of severe atypical hyperplasia,6 cases of papillary hyperplasia,4 cases of tubular adenosis and others were simple hyperplasia.Only one case of adenosis showed malignant change 10 years after operation.Conclusion The keys of clinical diagnosis are prevalence age,which is about 40 years old,irregular mastodynia and unilateral mass.Atypical dysplasia of ductal epithelium comfirmed by histology may determine the principle of diagnosis and therapy.It is necessary to make routine pathologic examination to prevent malignant change and missing diagnosis.
【Key words】 Mammary dysplasia Cystic hyperplasia

  乳腺结构不良症的晚期(乳腺囊性增生期)同腺病期的中、晚期(纤维性腺病及硬化性腺病)是与内分泌有关的乳腺组织重度增生,可能发展成为癌,已被视为癌前病变。但目前尚无明确的临床诊断标准,治疗意见不统一。本文就76例乳腺囊性增生期病人的临床特点、组织学改变、治疗原则及随访结果作一分析。

1 临床资料
  1986~1996年收入我院的196例乳腺结构不良症中,经病理组织学显示乳腺导管上皮不同程度增生与中、小导管的不同程度扩张,确诊为乳腺结构不良的囊性增生期疾病76例。年龄在35~55岁,中位数为45岁,36~48岁者占68.4%(52/76)。全部为已婚生育妇女。乳房痛不明

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