Abstract:

Objective To investigate the value of fiberoptic ductoscopy-guided intraductal biopsy in combination with the detection of

biomarker CA153 in diagnosis of early ductal pathological changes. Methods From May 2012 to October 2014，fiberoptic ductoscopy was performed on 123 nipple discharge patients, and patients diagnosed as breast intraductal neoplasm were given intraductal biopsy. The biopsy results were compared with pathology of duct excision. Nipple lavage fluid were collected from patients with intraductal neoplasm for the test of CA153，and 30 patients of intraductal dilatation were enrolled as control. Results Fifty-six patients who were found brest intraductal neoplasm among 123 patients underwent 64 times of fiberoptic ductoscopy-guided intraductal biospy and ductal lesions were removed. Among 56 patients underwent fiberoptic ductoscopy-guided intraductal biopsy，there were intraductal papilloma in 28 cases，mutiple intraductal papilloma in 7 cases，ductal hyperplasia in 6 cases，severe atypical ductal hyperplasias in 2 cases，and breast cancer was found in 7 cases. Biopsy failed in 6 patients， and the success rate of biopsy was 89.3％. All the patients underwent breast duct dissection. There were solitary intraductal papilloma in 29 cases，multiple intraductal papilloma in 11cases，ductal hyperplasia in 8 cases，atypical ductal hyperplasia in 1 case，intraductal carcinoma in 4 cases，invasive ductal carcinoma in 2 cases and intraductal papilloma carcinoma in 1 case. CA153 level of nipple lavage fluid in intraductal dilatation patients was（26.90±2.76）U／ml，lower than（31.91±22.95）U／ml of G3 grade（P＞0.05）,（52.67±33.63）U／ml of G4（P＜0.05）and（85.68±21.13）U／ml of G5 grade（P＜0.05）. Conclusion Fiberoptic ductoscopy-guided intraductal biopsy is microinvasive，safe，convenient with high success rate，and in combination with CA153 level in nipple lavage fluid shows certain values in diagnosing early ductal malignant changes.