The Comparative Study Of Traditional Production And Liquid Production Used In The Needle Biopsy Of Breast Tumors And The Determination Of ER, PR HER-2Expression

BackgroundIn clinical practice, the technique of fine needle aspiration is a widely used technologyin the identification of the nature of breast lumps, There are many ways to produce theSlide，such as the traditional producer of HE staining producer, Wright-Giemsa’sstaining producer and so on，the liquid based stain producer method is also large-scaleapplicated in clinical practice in recent years，and to be first and most applicated inuterus vaginal,a large number of studies have shown that the diagnostic accuracy,sensitivity are superior to traditional producers, comparative study of both producermethods in breast only has a small amount of foreign reports,not yet seeing domesticresearch. In addition, immunohistochemical indicators ER, PR and HER-2have greatclinical value in guiding breast cancer treatment and prognosis,there has a smallnumber of foreign studies which use the cell wax block made from the specimensthrough fine-needle aspiration of breast lumps to determine the express of ER, PR andHER-2,the results show that this method has a high degree of consistency with thepostoperative histopathological determination of ER, PR and HER-2,except for WangRuijuan has similar domestic reports,and not yet seeing other research in this area.ObjectiveThis study is aimed to compare the differences between the Traditional producer and theliquid-based producer in the diagnostic accuracy of fine needle aspiration of breast tumors；to understand the accuracy of preoperative determination of the ER, PR,HER-2expression through fine needle aspiration breast tissue；and to investigate thevalue of fine needle aspiration cytology in the early diagnosis of breast disease.MethodsWe select268cases of patients from the First Affiliated Hospital of Anhui MedicalUniversity outpatient and hospitalized in our department from fine needle cytologyexamination in June2009to June2011which using two kinds of producers oftraditional and liquid-based method at the same time.Among them，there were99casesof patients which have postoperative pathology，and there were169cases of patientswhich were followed up more than6months without postoperative pathology. We readthe slide which were producered on two different producer methods Separately to gainthe findings, in December2011we compared the findings with pathologic results andfollow-up results, and then analyzed statistically, and to compare the two producers inthe breast lumps diagnosis of the size of the coincidence rate; the pros and cons ofbreast cancer diagnostic sensitivity, specificity and positive and accurate rate. WeSelected in the above cases,33cases of highly suspected breast cancer patientsunderwent fine needle aspiration of breast lumps, the cells of wax block were madefrom the organization to Determine ER, PR, HER-2expression, the selected cases havesurgery immunohistochemical results for control, and we compared the preoperativeimmunohistochemical indicators of ER, PR, HER-2with the postoperative ones,toobserve the consistency of the level with postoperative immunohistochemistry.ResultsUsing traditional methods of producer to diagnosis breast lumps, the coincidence rate is79.9%,to diagnosis breast cancer, the diagnostic sensitivity of75.0%, specificity of98.5%, Positive predictive value of97.7%，Negative predictive value of82.5%，the positive rate of87.8%;while using liquid-based producer to diagnosis breast lumps, thecoincidence rate is90.7%, to diagnosis breast cancer, the diagnostic sensitivity of92.6%,specificity of100%, Positive predictive value of100%，Negative predictive valueof93.2%， the positive rate of96.3%.Liquid-based producer method has higherdiagnostic accuracy of breast masses and has a higher diagnostic sensitivity and positiveaccuracy of breast cancer(p〈0.05).To compare with the pathological, the consistency ofdetermination of ER, PR, HER-2expression was81.2%,78.8%,75.8%.ConclusionsTraditional producer and liquid-based producer method can both be applied to detect thenature of the breast lumps, to identify benign and malignant. Liquid-based producermethods have higher diagnostic accuracy of breast lumps(traditional producer79.9%,liquid-based producer90.7%,p〈0.001); have a higher diagnostic sensitivity(traditional producer75.0%, liquid-based producer92.6%p〈0.05)and Positive accuracyof breast cancer(traditional producer87.8%liquid-based producer96.3%,p〈0.05)。Thereis no significant difference between the determination of ER, PR, HER-2expression incells of wax block made from the organization through the fine needle aspiration ofbreast lumps and the pathological specimen determination,p〉0.05)，and can be used asone of the guiding reference for clinical treatment and predict prognosis of breast cancerpatients..