細針抽吸細胞學檢查在乳房腫瘤篩檢的角色：以某地區醫院的經驗評估其價值

The Role of Fine Needle Aspiration Cytology in the Breast Cancer Screening: The Experience from a Region Hospital

本文主要為回溯性研究，蒐集2004年1月至2012年12月至本研究醫院外科接受乳房細針抽吸細胞學（Fine Needle Aspiration Cytology，以下簡稱FNAC）檢查病患，共有265人次，其年齡分布，從17歲到99歲，平均年齡51.06歲。265人次中有69人次（平均年齡50.26歲）接受進一步切片確定診斷與治療，執行率為26%。本研究醫院之FNAC診斷正確率為85.7%; 無偽陽性（C4+C5偽陽性=0）；FNAC報告C2（良性）之偽陰性較高（佔27.2%）；FNAC報告C3（非典型）之惡性率佔13.6%，良性率佔32.3%;FNAC報告C2仍以良性疾病之比例較高。FNAC對乳癌篩檢的角色一直被公認為最簡便、最經濟、最迅速、安全的方法，雖然一直有更進步的診斷工具，然而強調只要有經驗豐富的三面式評估團隊，尤其是外科醫師臨床細針抽吸的技術與抹片技巧、放射學的診斷（包括超音波或乳房攝影）專業、以及細胞診斷經驗豐富的病理醫師，FNAC仍然可為快速正確篩檢或診斷乳癌的工具。另外，本文對FNAC之興衰過程及優缺點做進一步文獻回顧，並展望未來有更精緻的應用。

There were 265 visitors receiving fine needle aspiration cytology (FNAC) of the breast in our OPD from January 2004 to December 2012. We used our Laboratory Information System (LIS) to collect the data of FNAC, and checked their following histology. They were agefrom 17 to 99 years old with mean 51.06. Only 69 visitors received a further biopsy or excisional histologic confirmation. Our FNAC accurate diagnostic rate was 85.7%, and without false positive in C4nor C5. However, the false negative rate was 27.2%in C2. To our knowledge, FNAC is a good method for screening breast cancer, even if some more accurate methods have been used today, and the sensitivity and accurate diagnostic rate of FNAC is dependent on the triple assessment and their expert experiences. We also reviewed the literature about FNAC and their further application in future.