Diagnostic Value Of Nipple Discharge In Laticifers Endoscopy For Lavage Cytology

Objective:to evaluate the diagnostic value of lavage cytology to nipple discharge in laticifers endoscopy. Methods:Lavage cytology was done to Nipple discharge of 185 patients from June to September,2010, and abnormal spot of laticifers were lavaged and lavage liquid in the catheter were collected and done lavage cytology. Results:Patients diagnosed Laticifers expansion and inflammation by Laticifers endoscopy were 25 and they did not receive operation.79cases of 160 cases with breast mass received operation and done pathologic biopsies and one case of them was diagnosed atypical hyperplasia, 40cases were Milk tube papilloma,25cases were Ductal epithelial hyperplasia,13 cases were Mammary gland disease or with expansion, Main distribution of cell respectively ductal epithelial hyperplasia (100%), ductal epithelial hyperplasia (30%) and ductal epithelial cells (50%), ductal epithelial cells (48%), phagocytic cells (was 38.46%) and inflammatory cells (23.08%). Intraductal atypical hyperplasia much manifestation hemorrhagic nipple discharge, papilloma much performance is clear water samples and serum sample of nipple discharge, ductal epithelial hyperplasia much performance is clear water nipple discharge, duct expansion with inflammation much performance is milk samples of nipple discharge, and the accuracy of pathological examination was 83.54% (66/79). One intraductal lesions in different nipple discharge properties of breast of nipple discharge are statistically significant differences between patients (χ2=22.078, P=0. Expection), hemorrhagic and milk samples and clear water between nipple discharge was statistically significant (P<0.05), milk samples and serum sex between nipple discharge is statistically nipple discharge (P<0.05), groups of different age each intraductal lesions constitute the distribution of difference was statistically significant (χ2=17.081, P 0.047), papilloma occur in 40～50 years old, ductal epithelial hyperplasia and duct expansion with inflammation occur in is 30～40 years old. Postoperative pathologic conentional cytology, lavage cytology and laticifers endoscopy diagnostic accuracy between statistically significant ((χ2=145.08, P=0.000), its lavage cytology diagnostic accuracy of conventional cytology, fall off 82.27% diagnostic accuracy of 34.17%, laticifers endoscopy joint lavage cytology diagnostic accuracy of 96.20%(76/79), the diagnostic accuracy increased significantly.185 example, laticifers endoscopy downlink catheter lavage cytology smear-positie cells for 120 patients, nipple discharge liquid conventional shedding cytology smear-positie cells for 13 cases, catheter lavage fluid cytology smear positive cells lower amount nipple discharge liquid conventional cytology smear increased significantly (P=0.000).Conclusion:Laticifers endoscopy is more appropriate methods of intraductal lesions screening to the patients with pathologic nipple discharge and lavage cytology can improve the diagnostic efficiency. It will helpful for patients with hypothyroidism or pituitary tumor when consider intraductal lesions. Laticifers endoscopy is also helpful for the patients with nipple discharge to reduce the number and the range of the catheter removal. However, The results show that ductoscopic ductal lavage in nipple discharge can provide much more adequate specimens for exfoliative cytology and increase the diagnostic accuracy on nipple discharge.the potential application value of laticifers endoscopy and avage cytology on early diagnosis of breast cancer,the breast surgery guidance,therapeutic resection of intraductal lesions and reduction of the incidence of cancer of high-risk women need further study and evaluation.