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.	方晓义, 赵英杰, 高洪波, 等. 乳腺肿块的影像学诊断及良恶性鉴别的研究现状及进展. 罕少疾病杂志, 2013, 20(4): 48-50.
2.	孙永春, 王纯明, 孔秀莲. 乳腺肿块 628 例细针穿吸细胞学结果分析. 诊断病理学杂志, 2002, 9(4): 52.
3.	祁晓莉, 秦云, 王春艳, 等. 乳腺肿物针吸细胞学 2 624 例病例统计分析. 临床和实验医学杂志, 2015, 14(20): 1724-1726.
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6.	艾金伟, 李德胜, 刘羽, 等. 国内HLA-B27诊断强直性脊柱炎价值的 Meta 分析. 中国循证医学杂志, 2015, 15(9): 1059-1067.
7.	王四玲. 细针穿吸乳腺肿块 923 例临床病理分析. 肿瘤防治杂志, 2003, 10(10): 1114.
8.	赵芳, 郭建华, 杜娟. 乳腺肿物针吸细胞学结果分析 631 例. 湖北医药学院学报, 2011, 30(2): 201.
9.	黄玉军, 舒琦瑾. 细针穿刺细胞学检查在乳腺肿块诊断中的意义. 肿瘤学杂志, 2003, 9(2): 120-121.
10.	段旭艳. 乳腺肿块针吸细胞学 1 175 例分析. 菏泽医学专科学校学报, 2006, 18(4): 27-28.
11.	王品, 张松涛, 张守永. 乳房肿块患者细针穿刺细胞学检查及临床意义. 蚌埠医学院学报, 2007, 32(4): 475-476.
12.	李沛, 杭国琴, 许云, 等. 细针穿刺细胞学在乳腺肿块诊断中的临床应用. 检验医学与临床, 2013, 10(8): 944-945.
13.	王晓洁. 1 731 例乳腺肿块细针穿刺诊断的临床应用分析. 中国医药导报, 2011, 8(21): 97-98.
14.	余小蒙, 王卫东, 张长淮, 等. 对乳腺肿物针吸细胞学诊断标准的探讨—951 例细胞学与组织学的对照分析. 中华病理学杂志, 2002, 31(1): 26-29.
15.	王惠方. 乳腺肿块细针穿刺细胞学检查 1 024 例总结. 天津医药肿瘤学附刊, 1981, 08(3): 139-140.
16.	陶贵华, 刘自芬, 刘洪梅, 等. 乳腺肿物细针穿刺细胞学诊断的研究. 河南肿瘤学杂志, 2004, 17(5): 350-351.
17.	于庆凯, 杨文起, 杨继梅. 细针穿刺细胞学在乳腺肿块诊断中的应用. 山东医药, 2006, 46(7): 70-71.
18.	孙京杰, 曹莉莉, 时昌文. 687 例乳腺肿块的针吸细胞学检查结果分析. 山东医药, 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.	马纪周, 撖俊, 吴丹, 等. 细针穿刺在诊断乳腺包块中的应用. 齐齐哈尔医学院学报, 2010, 31(12): 1903.
27.	吴丽华. 针吸细胞学诊断乳腺肿块 376 例观察. 南通大学学报(医学版), 2006, 26(2): 122-123.
28.	叶倩, 饶金, 易艳平, 等. 乳腺肿块细针穿刺细胞学与组织病理学对照分析. 临床与实验病理学杂志, 2014, 30(1): 19-22.

1. 方晓义, 赵英杰, 高洪波, 等. 乳腺肿块的影像学诊断及良恶性鉴别的研究现状及进展. 罕少疾病杂志, 2013, 20(4): 48-50.
2. 孙永春, 王纯明, 孔秀莲. 乳腺肿块 628 例细针穿吸细胞学结果分析. 诊断病理学杂志, 2002, 9(4): 52.
3. 祁晓莉, 秦云, 王春艳, 等. 乳腺肿物针吸细胞学 2 624 例病例统计分析. 临床和实验医学杂志, 2015, 14(20): 1724-1726.
4. 周斌. 细针穿刺细胞学诊断乳腺肿块 516 例分析. 中外医学研究, 2011, 9(7): 45-46.
5. 曾宪涛, 庄丽萍, 杨宗国, 等. Meta 分析系列之七: 非随机实验性研究、诊断性试验及动物实验的质量评价工具. 中国循证心血管医学杂志, 2012, 4(6): 496-499.
6. 艾金伟, 李德胜, 刘羽, 等. 国内HLA-B27诊断强直性脊柱炎价值的 Meta 分析. 中国循证医学杂志, 2015, 15(9): 1059-1067.
7. 王四玲. 细针穿吸乳腺肿块 923 例临床病理分析. 肿瘤防治杂志, 2003, 10(10): 1114.
8. 赵芳, 郭建华, 杜娟. 乳腺肿物针吸细胞学结果分析 631 例. 湖北医药学院学报, 2011, 30(2): 201.
9. 黄玉军, 舒琦瑾. 细针穿刺细胞学检查在乳腺肿块诊断中的意义. 肿瘤学杂志, 2003, 9(2): 120-121.
10. 段旭艳. 乳腺肿块针吸细胞学 1 175 例分析. 菏泽医学专科学校学报, 2006, 18(4): 27-28.
11. 王品, 张松涛, 张守永. 乳房肿块患者细针穿刺细胞学检查及临床意义. 蚌埠医学院学报, 2007, 32(4): 475-476.
12. 李沛, 杭国琴, 许云, 等. 细针穿刺细胞学在乳腺肿块诊断中的临床应用. 检验医学与临床, 2013, 10(8): 944-945.
13. 王晓洁. 1 731 例乳腺肿块细针穿刺诊断的临床应用分析. 中国医药导报, 2011, 8(21): 97-98.
14. 余小蒙, 王卫东, 张长淮, 等. 对乳腺肿物针吸细胞学诊断标准的探讨—951 例细胞学与组织学的对照分析. 中华病理学杂志, 2002, 31(1): 26-29.
15. 王惠方. 乳腺肿块细针穿刺细胞学检查 1 024 例总结. 天津医药肿瘤学附刊, 1981, 08(3): 139-140.
16. 陶贵华, 刘自芬, 刘洪梅, 等. 乳腺肿物细针穿刺细胞学诊断的研究. 河南肿瘤学杂志, 2004, 17(5): 350-351.
17. 于庆凯, 杨文起, 杨继梅. 细针穿刺细胞学在乳腺肿块诊断中的应用. 山东医药, 2006, 46(7): 70-71.
18. 孙京杰, 曹莉莉, 时昌文. 687 例乳腺肿块的针吸细胞学检查结果分析. 山东医药, 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. 马纪周, 撖俊, 吴丹, 等. 细针穿刺在诊断乳腺包块中的应用. 齐齐哈尔医学院学报, 2010, 31(12): 1903.
27. 吴丽华. 针吸细胞学诊断乳腺肿块 376 例观察. 南通大学学报(医学版), 2006, 26(2): 122-123.
28. 叶倩, 饶金, 易艳平, 等. 乳腺肿块细针穿刺细胞学与组织病理学对照分析. 临床与实验病理学杂志, 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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