Ductal lavage for detection of cellular atypia in women at high risk for breast cancer
Ductal lavage for detection of cellular atypia in women at high risk for breast cancer
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DOI：
10.1093/jnci/93.21.1624
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发表时间：
2001-11-07
期刊：
影响因子：
--
通讯作者：
King, EB
中科院分区：
文献类型：
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作者：
Dooley, WC;Ljung, BM;King, EB
乳腺癌起源于乳腺上皮，与进行性分子和形态改变有关。患有非典型乳腺导管上皮细胞的女性患乳腺癌的相对风险增加。在这项研究中，导管灌洗（一种用微导管收集导管细胞的新方法）与乳头抽吸在安全性、耐受性和检测异常乳腺上皮细胞的能力方面进行了比较。方法：乳腺癌高危妇女，无可疑乳房x光检查和临床乳房检查均行乳头抽吸，然后灌洗产液导管。所有统计检验均为双侧检验。结果：入选的507名女性中，有291名（57%）有乳腺癌病史，199名（39%）5年乳腺癌Gail风险为1.7%或更高。对417名妇女的乳头抽吸液（NAF）样本进行细胞学评估，对383名妇女的导管灌洗样本进行评估。分别从3例（27%）和299例（78%）妇女中收集了足够的诊断样本。导管灌洗法平均每个乳腺收集13500个上皮细胞（范围43- 492000个），而乳头抽吸法平均每个乳腺收集120个上皮细胞（范围10- 74300个）。在导管灌洗中，92例（24%）受试者有轻度（17%）或明显（6%）不典型或恶性的异常细胞(
Breast cancer originates in breast epithelium and is associated with progressive molecular and morphologic changes. Women with atypical breast ductal epithelial cells have an increased relative risk of breast cancer. In this study, ductal lavage, a new procedure for collecting ductal cells with a microcatheter, was compared with nipple aspiration with regard to safety, tolerability, and the ability to detect abnormal breast epithelial cells. Methods: Women at high risk for breast cancer who had nonsuspicious mammograms and clinical breast examinations underwent nipple aspiration followed by lavage of fluid-yielding ducts. All statistical tests were two-sided. Results: The 507 women enrolled included 291 (57%) with a history of breast cancer and 199 (39%) with a 5-year Gail risk for breast cancer of 1.7% or more. Nipple aspirate fluid (NAF) samples were evaluated cytologically for 417 women, and ductal lavage samples were evaluated for 383 women. Adequate samples for diagnosis were collected from III (27%) and 299 (78%) women, respectively. A median of 13 500 epithelial cells per duct (range, 43-492 000 cells) was collected by ductal lavage compared with a median of 120 epithelial cells per breast (range, 10-74 300) collected by nipple aspiration. For ductal lavage, 92 (24%) subjects had abnormal cells that were mildly (17%) or markedly (6%) atypical or malignant (