Diagnostic value of fine-needle biopsies for benign and malignant breast nodules: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 XU Feng ¹ , GE Shujun ¹ , CHEN Chen ¹ , ZHAO Xiaoxue ¹ , SHI Xinyu ²

1. The Forth Clinical College, Hubei University of Medicine, Shiyan, 442000, P.R.China;
2. Biomedical Engineering Collage, Hubei University of Medicine, Shiyan, 442000, P.R.China;

Corresponding?author：

XU Feng, Email: xf5426@163.com

Keywords：

Breast nodule; Fine-needle biopsies; Biopsy; Diagnosis; Meta-analysis

DOI：

10.7507/1672-2531.201608052

Video：

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ObjectiveTo systematically review the value of the fine-needle biopsies in the diagnosis of benign and malignant breast nodules. MethodsA computer based online search was conducted in PubMed, The Cochrane Library (Issue 7, 2016), EMbase, CBM, CNKI, VIP, WanFang Data databases up to August, 2016 to collect the relevant diagnostic studies of the fine-needle biopsies for benign and malignant breast nodules. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using Stata 12.0 and Meta-Disc 1.4 software.ResultsA total of 22 studies involving 24 496 patients were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, –LR, and DOR were 0.95 (95%CI 0.95 to 0.96), 0.96 (95%CI 0.96 to 0.96), 38.27 (95%CI 23.17 to 63.19), 0.05 (95%CI 0.03 to 0.07), 1 031.11 (95%CI 514.19 to 2 067.68), respectively. The AUC of SROC was 0.99 (95%CI 0.98 to 1.00).ConclusionThe current evidence indicates that the FNAC has high diagnostic value in the differential diagnosis of benign and malignant breast nodules.

Citation： XU Feng, GE Shujun, CHEN Chen, ZHAO Xiaoxue, SHI Xinyu. Diagnostic value of fine-needle biopsies for benign and malignant breast nodules: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(6): 644-651. doi: 10.7507/1672-2531.201608052 Copy

1.	方曉義, 趙英杰, 高洪波, 等. 乳腺腫塊的影像學診斷及良惡性鑒別的研究現狀及進展. 罕少疾病雜志, 2013, 20(4): 48-50.
2.	孫永春, 王純明, 孔秀蓮. 乳腺腫塊 628 例細針穿吸細胞學結果分析. 診斷病理學雜志, 2002, 9(4): 52.
3.	祁曉莉, 秦云, 王春艷, 等. 乳腺腫物針吸細胞學 2 624 例病例統計分析. 臨床和實驗醫學雜志, 2015, 14(20): 1724-1726.
4.	周斌. 細針穿刺細胞學診斷乳腺腫塊 516 例分析. 中外醫學研究, 2011, 9(7): 45-46.
5.	曾憲濤, 莊麗萍, 楊宗國, 等. Meta 分析系列之七: 非隨機實驗性研究、診斷性試驗及動物實驗的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(6): 496-499.
6.	艾金偉, 李德勝, 劉羽, 等. 國內HLA-B27診斷強直性脊柱炎價值的 Meta 分析. 中國循證醫學雜志, 2015, 15(9): 1059-1067.
7.	王四玲. 細針穿吸乳腺腫塊 923 例臨床病理分析. 腫瘤防治雜志, 2003, 10(10): 1114.
8.	趙芳, 郭建華, 杜娟. 乳腺腫物針吸細胞學結果分析 631 例. 湖北醫藥學院學報, 2011, 30(2): 201.
9.	黃玉軍, 舒琦瑾. 細針穿刺細胞學檢查在乳腺腫塊診斷中的意義. 腫瘤學雜志, 2003, 9(2): 120-121.
10.	段旭艷. 乳腺腫塊針吸細胞學 1 175 例分析. 菏澤醫學專科學校學報, 2006, 18(4): 27-28.
11.	王品, 張松濤, 張守永. 乳房腫塊患者細針穿刺細胞學檢查及臨床意義. 蚌埠醫學院學報, 2007, 32(4): 475-476.
12.	李沛, 杭國琴, 許云, 等. 細針穿刺細胞學在乳腺腫塊診斷中的臨床應用. 檢驗醫學與臨床, 2013, 10(8): 944-945.
13.	王曉潔. 1 731 例乳腺腫塊細針穿刺診斷的臨床應用分析. 中國醫藥導報, 2011, 8(21): 97-98.
14.	余小蒙, 王衛東, 張長淮, 等. 對乳腺腫物針吸細胞學診斷標準的探討—951 例細胞學與組織學的對照分析. 中華病理學雜志, 2002, 31(1): 26-29.
15.	王惠方. 乳腺腫塊細針穿刺細胞學檢查 1 024 例總結. 天津醫藥腫瘤學附刊, 1981, 08(3): 139-140.
16.	陶貴華, 劉自芬, 劉洪梅, 等. 乳腺腫物細針穿刺細胞學診斷的研究. 河南腫瘤學雜志, 2004, 17(5): 350-351.
17.	于慶凱, 楊文起, 楊繼梅. 細針穿刺細胞學在乳腺腫塊診斷中的應用. 山東醫藥, 2006, 46(7): 70-71.
18.	孫京杰, 曹莉莉, 時昌文. 687 例乳腺腫塊的針吸細胞學檢查結果分析. 山東醫藥, 2007, 47(18): 94.
19.	Sheikh FA, Tinkoff GH, Kline TS, et al. Final diagnosis by fine-needle aspiration biopsy for definitive operation in breast cancer. Am J Surg, 1987, 154(5): 470-474.
20.	Ariga R, Bloom K, Reddy VB, et al. Fine-needle aspiration of clinically suspicious palpable breast masses with histopathologic correlation. Am J Surg, 2002, 184(5): 410-413.
21.	Sauer T, Myrvold K, Lomo J, et al. Fine-needle aspiration cytology in nonpalpable mammographic abnormalities in breast cancer screening: results from the breast cancer screening programme in Oslo 1996-2001. Breast, 2003, 12(5): 314-319.
22.	Dong J, Ly A, Arpin R, et al. Breast fine needle aspiration continues to be relevant in a large academic medical center: experience from Massachusetts General Hospital. Breast Cancer Res Treat, 2016, 158(2): 297-305.
23.	Horgan PG, Waldron D, Mooney E, et al. The role of aspiration cytologic examination in the diagnosis of carcinoma of the breast. Surg Gynecol Obstet, 1991, 172(4): 290-292.
24.	Ciatto S, Cecchini S, Grazzini G, et al. Positive predictive value of fine needle aspiration cytology of breast lesions. Acta Cytol, 1989, 33(6): 894-898.
25.	Farshid G, Downey P, Gill P, et al. Assessment of 1183 screen-detected, category 3B, circumscribed masses by cytology and core biopsy with long-term follow up data. Br J Cancer, 2008, 98(7): 1182-1190.
26.	馬紀周, 撖俊, 吳丹, 等. 細針穿刺在診斷乳腺包塊中的應用. 齊齊哈爾醫學院學報, 2010, 31(12): 1903.
27.	吳麗華. 針吸細胞學診斷乳腺腫塊 376 例觀察. 南通大學學報(醫學版), 2006, 26(2): 122-123.
28.	葉倩, 饒金, 易艷平, 等. 乳腺腫塊細針穿刺細胞學與組織病理學對照分析. 臨床與實驗病理學雜志, 2014, 30(1): 19-22.

1. 方曉義, 趙英杰, 高洪波, 等. 乳腺腫塊的影像學診斷及良惡性鑒別的研究現狀及進展. 罕少疾病雜志, 2013, 20(4): 48-50.
2. 孫永春, 王純明, 孔秀蓮. 乳腺腫塊 628 例細針穿吸細胞學結果分析. 診斷病理學雜志, 2002, 9(4): 52.
3. 祁曉莉, 秦云, 王春艷, 等. 乳腺腫物針吸細胞學 2 624 例病例統計分析. 臨床和實驗醫學雜志, 2015, 14(20): 1724-1726.
4. 周斌. 細針穿刺細胞學診斷乳腺腫塊 516 例分析. 中外醫學研究, 2011, 9(7): 45-46.
5. 曾憲濤, 莊麗萍, 楊宗國, 等. Meta 分析系列之七: 非隨機實驗性研究、診斷性試驗及動物實驗的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(6): 496-499.
6. 艾金偉, 李德勝, 劉羽, 等. 國內HLA-B27診斷強直性脊柱炎價值的 Meta 分析. 中國循證醫學雜志, 2015, 15(9): 1059-1067.
7. 王四玲. 細針穿吸乳腺腫塊 923 例臨床病理分析. 腫瘤防治雜志, 2003, 10(10): 1114.
8. 趙芳, 郭建華, 杜娟. 乳腺腫物針吸細胞學結果分析 631 例. 湖北醫藥學院學報, 2011, 30(2): 201.
9. 黃玉軍, 舒琦瑾. 細針穿刺細胞學檢查在乳腺腫塊診斷中的意義. 腫瘤學雜志, 2003, 9(2): 120-121.
10. 段旭艷. 乳腺腫塊針吸細胞學 1 175 例分析. 菏澤醫學專科學校學報, 2006, 18(4): 27-28.
11. 王品, 張松濤, 張守永. 乳房腫塊患者細針穿刺細胞學檢查及臨床意義. 蚌埠醫學院學報, 2007, 32(4): 475-476.
12. 李沛, 杭國琴, 許云, 等. 細針穿刺細胞學在乳腺腫塊診斷中的臨床應用. 檢驗醫學與臨床, 2013, 10(8): 944-945.
13. 王曉潔. 1 731 例乳腺腫塊細針穿刺診斷的臨床應用分析. 中國醫藥導報, 2011, 8(21): 97-98.
14. 余小蒙, 王衛東, 張長淮, 等. 對乳腺腫物針吸細胞學診斷標準的探討—951 例細胞學與組織學的對照分析. 中華病理學雜志, 2002, 31(1): 26-29.
15. 王惠方. 乳腺腫塊細針穿刺細胞學檢查 1 024 例總結. 天津醫藥腫瘤學附刊, 1981, 08(3): 139-140.
16. 陶貴華, 劉自芬, 劉洪梅, 等. 乳腺腫物細針穿刺細胞學診斷的研究. 河南腫瘤學雜志, 2004, 17(5): 350-351.
17. 于慶凱, 楊文起, 楊繼梅. 細針穿刺細胞學在乳腺腫塊診斷中的應用. 山東醫藥, 2006, 46(7): 70-71.
18. 孫京杰, 曹莉莉, 時昌文. 687 例乳腺腫塊的針吸細胞學檢查結果分析. 山東醫藥, 2007, 47(18): 94.
19. Sheikh FA, Tinkoff GH, Kline TS, et al. Final diagnosis by fine-needle aspiration biopsy for definitive operation in breast cancer. Am J Surg, 1987, 154(5): 470-474.
20. Ariga R, Bloom K, Reddy VB, et al. Fine-needle aspiration of clinically suspicious palpable breast masses with histopathologic correlation. Am J Surg, 2002, 184(5): 410-413.
21. Sauer T, Myrvold K, Lomo J, et al. Fine-needle aspiration cytology in nonpalpable mammographic abnormalities in breast cancer screening: results from the breast cancer screening programme in Oslo 1996-2001. Breast, 2003, 12(5): 314-319.
22. Dong J, Ly A, Arpin R, et al. Breast fine needle aspiration continues to be relevant in a large academic medical center: experience from Massachusetts General Hospital. Breast Cancer Res Treat, 2016, 158(2): 297-305.
23. Horgan PG, Waldron D, Mooney E, et al. The role of aspiration cytologic examination in the diagnosis of carcinoma of the breast. Surg Gynecol Obstet, 1991, 172(4): 290-292.
24. Ciatto S, Cecchini S, Grazzini G, et al. Positive predictive value of fine needle aspiration cytology of breast lesions. Acta Cytol, 1989, 33(6): 894-898.
25. Farshid G, Downey P, Gill P, et al. Assessment of 1183 screen-detected, category 3B, circumscribed masses by cytology and core biopsy with long-term follow up data. Br J Cancer, 2008, 98(7): 1182-1190.
26. 馬紀周, 撖俊, 吳丹, 等. 細針穿刺在診斷乳腺包塊中的應用. 齊齊哈爾醫學院學報, 2010, 31(12): 1903.
27. 吳麗華. 針吸細胞學診斷乳腺腫塊 376 例觀察. 南通大學學報(醫學版), 2006, 26(2): 122-123.
28. 葉倩, 饒金, 易艷平, 等. 乳腺腫塊細針穿刺細胞學與組織病理學對照分析. 臨床與實驗病理學雜志, 2014, 30(1): 19-22.

Chinese Journal of Evidence-Based Medicine

Diagnostic value of fine-needle biopsies for benign and malignant breast nodules: a meta-analysis

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