56例卵巢上皮性交界性肿瘤的临床和病理分析

目的：探讨卵巢交界性上皮肿瘤（OBT）的临床及病理特征,以供临床和病理借鉴.方法：收集病理快速冰冻切片和石蜡切片确诊的交界性上皮性卵巢肿瘤患者56例,术前均行超声检查及CA125测定.结果：56例OBT中以粘液性肿瘤最多,为33例,占58.9%,浆液性肿瘤23例占41.1%.其中以Ⅰ期多见,手术包括保守性手术治疗交界性肿瘤,预后良好.冰冻切片诊断卵巢交界性上皮肿瘤的总体准确率为64.2%.结论：诊断OBT需根据临床症状、肿瘤标记物及影像学综合判断,术中冰冻切片检查有一定帮助,但最后诊断还是应主要依据病理切片.为提高快速冰冻切片诊断的准确率,应做连续切片.     

冰冻切片与石蜡切片对乳腺肿瘤的诊断价值研究

目的:分析和比较冰冻切片与石蜡切片对乳腺肿瘤的诊断价值。方法:选取480例新鲜乳腺标本,将其制成冰冻切片以及石蜡切片,根据诊断结果进行对比分析,评价乳腺肿瘤的冰冻切片与石蜡切片的对乳腺肿瘤的诊断价值。结果:经石蜡切片诊断乳腺良性肿瘤277例,占57.71%,良性肿瘤中以乳腺纤维瘤诊断居多;经石蜡切片诊断乳腺恶性肿瘤203例,占42.29%,以乳腺浸润性导管癌居多。冰冻切片诊断乳腺良性肿瘤279例,占58.13%;恶性肿瘤195例,占40.62%;延迟诊断6例,占1.25%。以石蜡切片诊断结果为金标准,冰冻切片诊断乳腺良性肿瘤的准确率为98.56%(273/277),诊断恶性肿瘤的准确率为95.07%(193/203),假阳性率为0.72%(2/277),假阴性率为2.96%(6/203),冰冻切片与石蜡切片诊断乳腺肿瘤的结果具有显著一致性,K值为0.965(P0.05)。结论:冰冻切片与石蜡切片诊断乳腺肿瘤的符合率较高,可作为术中快速病理检测的手段,但该种切片方式存在少量延迟诊断,多与术者操作经验有关,故术中应注重制片过程,提高冰冻切片质量。     

卵巢上皮性癌中干扰素介导的跨膜蛋白1的表达意义

目的:探讨干扰素介导的跨膜蛋白1(Interferon-induced transmembrane protein 1,IFITM1)基因在卵巢上皮性癌中表达的相关性及其意义。方法:应用Western blotting检测正常卵巢、卵巢良性肿瘤、卵巢交界性肿瘤和卵巢上皮性癌组织中IFITM1蛋白表达。免疫组织化学检测12例正常卵巢、21例卵巢良性肿瘤、18例卵巢交界性肿瘤和85例卵巢上皮性癌组织中IFITM1的蛋白表达,同时分析IFITM1表达状况与临床病理因素之间的相关性。结果:Western blotting显示卵巢上皮性癌和卵巢交界性肿瘤中IFITM1表达水平明显高于正常卵巢组织和卵巢良性肿瘤。免疫组化显示在正常卵巢组织中IFITM1阳性表达率为41.7%(5/12),在卵巢良性肿瘤组织中71.4%(15/21),在卵巢交界性肿瘤组织中为72.2%(13/18),在卵巢上皮性癌中为77.6%(66/85),IFITM1蛋白表达强度在正常卵巢、良性卵巢肿瘤、交界性卵巢肿瘤、上皮性卵巢癌间的比较有统计学意义(P0.05)。IFITM1蛋白表达与病理类型、肿瘤分化程度、肿瘤FIGO分期有关(P0.05),与淋巴结转移、腹水无明显相关性。化疗敏感组和耐药组的IFITM1表达强度间差异有统计学意义(P0.05)。结论:IFITM1在正常卵巢、卵巢良性肿瘤、卵巢交界性肿瘤和卵巢上皮性癌组织中的表达依次升高,并与卵巢癌以铂类为基础的化疗耐药性产生有相关性,为进一步研究IFITM1在卵巢癌诊治及化疗中的应用前景提供依据。     

卵巢上皮性肿瘤中FKBP38 蛋白的表达研究

目的:探讨卵巢上皮性肿瘤中FK506结合蛋白38(FK506-binding protein 38,FKBP38)蛋白的表达及潜在的临床意义。方法:采用免疫组化的方法检测20例正常输卵管组织,30例卵巢上皮性良性肿瘤,27例卵巢交界性肿瘤组织,130例卵巢上皮性癌(epithelial ovarian carcinoma,EOC)组织中FKBP38蛋白的表达,并分析其表达水平与临床病理参数的关系。结果:FKBP38蛋白在卵巢上皮性癌中的表达明显低于正常输卵管组织、卵巢上皮性良性和交界性肿瘤组织,差异有统计学意义(P0.05)。FKBP38蛋白表达在根据国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)标准定义的不同分期的卵巢上皮性癌组织中具有统计学差异(P0.05)。FKBP38蛋白在卵巢高级别浆液性癌的表达比低级别浆液性癌中的表达显著性降低(P0.05)。但把卵巢上皮性癌按照不同年龄及不同组织学分型分层后,FKBP38蛋白表达差异无统计学意义(P0.05)。结论:FKBP38蛋白表达的下调可能与卵巢上皮性癌的发生和分化密切相关,提示FKBP38蛋白作为卵巢恶性肿瘤诊断和治疗的潜在性生物靶点需进一步探索和研究。     

E-cadherin,β-catenin,N-cadherin在卵巢浆液性癌中的表达及意义

目的研究浆液性卵巢癌中E-钙粘蛋白(E-cadherin,E-cad),β-连环蛋白(β-catenin,β-cat),N-钙粘蛋白(N-cadherin,N-cad)的表达,探讨其相关性及临床意义。方法采用免疫组织化学法检测60例卵巢浆液性癌中E-cadherin,β-catenin and N-cadherin的表达。结果 E-cadherin,β-catenin在卵巢浆液性癌、卵巢浆液性良性肿瘤和卵巢交界性肿瘤及正常卵巢组织间差异有统计学意义(P0.05),而在卵巢良性肿瘤和卵巢交界性肿瘤间,差异不大,无统计学意义(P0.05)。N-cadherin在卵巢浆液性癌与卵巢交界性肿瘤,卵巢浆液性良性瘤及正常卵巢组织间差异有统计学意义(P0.05),而在正常卵巢组织、卵巢良性肿瘤和卵巢交界性肿瘤间,无差异,无统计学意义。结论 E-钙粘蛋白(E-cadherin),β-连环蛋白(β-catenin),N-钙粘蛋白(N-cadherin)在浆液性卵巢癌中均存在异常表达。提示三种因子可能造成肿瘤的发生、发展、侵袭及转移。三者同时检测,可能为早期诊断上皮性卵巢癌及针对上皮性卵巢癌的靶向治疗提供分子依据及新的思路。     

Skp2和P27在上皮性卵巢癌中表达及其临床意义

目的:检测Skp2和P27在上皮性卵巢癌中的表达,分析Skq2和P27与临床病理特征间的关系,探讨二者在上皮性卵巢癌发生发展中的作用.方法:应用免疫组织化学SP法,检测69例上皮性卵巢癌、15例良性卵巢肿瘤以及15例正常卵巢组织中Skp2和P27的表达,分析Skp2和P27表达与上皮性卵巢癌临床病理参数的关系,及两者的相关性.结果:上皮性卵巢癌、良性卵巢肿瘤及正常卵巢组织Skp2和P27表达阳性率各为42.02%,26.67%、6.67%和47.82%,66.67%、86.67%,差异有统计学意义(P<0.05).Skp2的表达与临床分期和病理组织学分级显著相关,与患者年龄、病理类型、有无淋巴结转移和肿瘤大小无显著相关.P27的表达与临床分期、有无淋巴结转移和病理组织学分级显著相关,与患者年龄、病理类型和肿瘤大小无显著相关.Skp2和P27在上皮性卵巢癌中表达呈显著负相关,相关系数r=-0.463,(P<0.01).结论:Skp2与P27呈负相关,二者表达可能与上皮性卵巢癌的发生发展有关.     

人附睾蛋白4作为卵巢癌生物标志物的初步研究

目的:探讨人附睾蛋白4(HE4)在卵巢癌组织和血清中的表达及其临床病理意义。方法:用免疫组织化学技术检测正常卵巢,卵巢良性上皮性肿瘤,交界性上皮性肿瘤和癌组织中HE4的表达,并分析其与临床分期和预后的关系;用ELISA方法检测患者血清中HE4的含量。结果:HE4在浆液性乳头状囊腺癌组织中的阳性表达率要显著高于交界性肿瘤,良性肿瘤和正常组织,而交界性肿瘤阳性表达率显著高于良性肿瘤和正常对照。HE4表达与临床分期没有显著相关性。HE4阳性患者的平均生存期、5年生存率和中位生存期均显著低于HE4阴性患者。卵巢癌和交界性肿瘤患者血清中HE4含量显著高于良性肿瘤和正常对照组。结论:HE4可能作为卵巢癌诊断和预后的组织和血清标志物。     

CD31和CD105在卵巢上皮性肿瘤中的表达及其临床病理意义

目的探讨CD31和CD105在卵巢上皮性肿瘤及正常卵巢组织中的表达情况及其与卵巢肿瘤生物学行为之间的关系,并比较同为肿瘤血管内皮标记物的CD31和CDl05在标记微血管方面的差异。方法收集天津市肿瘤医院临床、病理和预后资料完整的恶性卵巢上皮性肿瘤组织标本76例,病例标本采用免疫组化EnVision法检测CD31和CD105所标记的MVD数值,MVD计数参照Weidner方法进行量化分析,实验同时取20例交界性卵巢上皮性肿瘤、10例良性卵巢上皮性肿瘤和10例宫颈癌手术中切除的正常卵巢组织作为对照。结果①CD31蛋白在卵巢上皮性肿瘤的微血管和大血管上均有较强表达,在正常卵巢组织血管中亦有表达,恶性卵巢肿瘤中的MVD-CD31值（5．484-_0．75）显著高于交界性卵巢肿瘤（2．24±0．61）、良性卵巢肿瘤（2．24土0．41）及正常卵巢组织（1．20±0．37）（P〈0．01）;在卵巢癌中,MVD-CD31值仅与有无淋巴结转移及组织学分级之间的差异有统计学意义（P〈O．05）,而与年龄、病理类型、肿瘤大小、腹水、有无远处转移无关（P〉0．05）。②CDl05蛋白在卵巢肿瘤微血管中有表达,在正常卵巢组织中呈微弱表达或无表达,恶性卵巢肿瘤中的MVD-CDl05值（4．07士2．11）显著高于交界性卵巢肿瘤（2．08土0．30）、良性卵巢肿瘤（1．92±1．15）及正常卵巢组织（O．68±0．39）（P〈0．05或P〈0．01）;在卵巢癌中MV口CDl05值与组织学分级、有无腹水、有无远处转移、有无淋巴结转移有关（P〈0．05）,而与年龄、病理类型、肿瘤大小等因素无关（P〉0．05）。③恶性肿瘤组织中的MVD-CD31值显著高于MVD-CDl05值（P〈0．05）。结论在标染卵巢癌方面,CDl05比CD31有明显优越性,CDl05的表达与卵巢癌的生物学行为密切相关,MVD-CDl05值的检测可更准确的确定肿瘤的临床分期、指导治疗及判断预后。     

c-Src在上皮性卵巢癌组织中的表达及意义

目的:探讨上皮性卵巢癌组织中细胞肉瘤蛋白(Cell sarcoma,c-Src)的表达及其其临床意义。方法:通过Western blotting方法检测4例正常卵巢组织及21例上皮性卵巢组织中c-Src蛋白的表达。同时,通过免疫组化的方法检测26例正常卵巢组织和134例上皮性卵巢癌组织中c-Src的表达。统计分析c-Src的表达与上皮性卵巢肿瘤的临床病理因素之间的关系。结果:与正常卵巢组织相比,上皮性卵巢癌组织中c-Src蛋白的表达明显增高。c-Src蛋白的过表达与上皮性卵巢癌患者的临床病理分期、组织学分化程度、淋巴结转移情况及肿瘤复发之间差异存在统计学意义(P0.05),但与患者的年龄等因素均无显著相关性(P0.05)。此外,c-Src蛋白的高表达,与上皮性卵巢癌患者的预后密切相关(P0.05)。结论:c-Src在上皮性卵巢癌组织中过表达,且与肿瘤的恶性生物学行为密切相关,可能作为评估上皮性卵巢癌恶性程度、病情进展的重要指标及分子靶向疗法的新靶点。     

卵巢混合性生殖细胞肿瘤12例临床病理分析

目的探讨原发卵巢混合性生殖细胞肿瘤(MGCT)的临床病理特点及鉴别诊断。方法回顾性分析12例原发性卵巢MGCT患者的临床病理资料,对其临床表现、预后、组织形态和免疫组化结果进行分析。结果卵巢MGCT占我院同期卵巢生殖细胞肿瘤的12.2%(12/98),卵巢MGCT可由多种生殖细胞肿瘤成分组成,镜下形态多样,肿瘤成分包括无性细胞瘤、卵黄囊瘤、畸胎瘤、胚胎性癌、绒毛膜癌。其中9例(75%)包含2种不同的生殖细胞肿瘤成分,2例(16.7%)包含3种不同的肿瘤成分,1例(8.3%)包含4种不同的肿瘤成分。结论卵巢MGCT非常少见,肿瘤的生物学行为、临床治疗和预后的不同与其所含成分相关,准确的病理诊断非常必要,免疫组化标记对病理诊断与鉴别诊断具有重要作用。     

Banking of fresh-frozen prostate tissue using the alternate mirror image protocol: methods, validation, and impact on the pathological prognostic parameters in radical prostatectomy

We evaluated the value of the ‘alternative slices mirror image method’ used in prostate tissue banking in terms of predicting the sampling of cancerous tissue while preserving the pathological prognostic information. The concordance of diagnosis between banked sections and their mirror image paraffin- sections was studied using 50 cases corresponding to 400 H&E sections taken from 400 banked frozen blocks (two presumed benign and two presumed cancer for each case). The mean number of paraffin blocks in each case was 21. On average 29% of the prostate gland was banked and banked tissue contained cancer in 47 cases (94%). There was no difference between the concordant and discordant groups in terms of the final Gleason score, pathological stage, prostate size, number of banked blocks and the percentage of the prostate submitted for banking. However, concordant cases had larger foci of cancer in the mirror image paraffin block (P?=?0.0088). In addition, the surgical margins sections which are not banked using this method provided important information about the pathological stage, surgical margins status and the final Gleason score in 2.6, 2.6, and 1.3% of cases, respectively. The ‘alternative slices mirror image method’ is a straightforward method that is highly efficient in banking prostatic cancerous tissue. Overall, tumor volume and especially size of tumor foci in the image paraffin block are the most important factors in dictating the success rate of banking frozen cancerous tissue. Including ‘surgical margins’ sections for histology provides additional important prognostic information in a minority of cases.     

Cytopathology of the central nervous system. Part I. Utility of crush smear cytology in intraoperative diagnosis of central nervous system lesions

OBJECTIVE: To evaluate the utility of rapid intraoperative crush smear cytologic diagnosis of central and peripheral nervous system lesions and to determine the accuracy and relevance of the accuracy of the intraoperative cytologic diagnosis when compared to the final paraffin section diagnosis. STUDY DESIGN: The crush (squash) smear technique was introduced at Sher-i-Kashmir Institute of Medical Sciences in May 2003. The 8 months of 2003 were used for standardization of the procedure. In 2004, 151 patients with open neurosurgical specimens or stereotactic biopsies were diagnosed intraoperatively by crush smears, and the diagnosis was compared with final diagnosis on paraffin sections of the same tissue samples. No supplementation of frozen sections was used. RESULTS: Of 151 cases, 144 were diagnosed accurately intraoperatively by crush smear cytology when compared with the respective paraffin section diagnoses. The diagnostic accuracy attained was 95.36%. Each case was diagnosed within 10 minutes after receipt of sample. Neurosurgical procedure (open or stereotaxy) did not affect diagnostic accuracy. CONCLUSION: In the expert hands of a pathologist with good exposure neurosurgical specimens, crush smear cytology is an accura and reliable procedure for the intraoperative diagnosis central nervous system tumors.     

补肾益气活血汤对小鼠血清雌、孕激素浓度 及其受体表达的影响

目的：探讨中药补肾益气活血汤促进着床的机理。方法：在以吲哚美辛建立小鼠着床障碍模型的基础上,将动物分为正常组,吲哚美辛组,中药组和黄体酮组,用放射免疫、免疫组织化学及Westem—blot方法检测各组小鼠妊娠d5（围着床期）血清皿,P4浓度及子宫内膜ER,PR表达。结果：补肾益气活血中药对E2、P4水平无明显影响,对PR表达也无明显影响,但有轻度促进ERα表达作用,此外,实验发现治疗对照组注射黄体酮虽然使P4水平升高,但ERα、PR表达却都有一定下降。结论：提示中药补肾益气活血汤可能主要通过雌激素样活性加强E2与其受体作用而有利于发动蜕膜化从而促进着床,黄体酮辅助生殖治疗失败可能与孕酮一定程度上抑制ERα和PR表达有关。     

肿瘤淋巴管入侵与无淋巴结转移膀胱癌复发及预后的相关性分析

目的:分析肿瘤淋巴管入侵与无淋巴结转移膀胱癌复发和预后之间的关系。方法:选取临床资料完整的膀胱癌病例72例,分为淋巴结转移组(32例)和无淋巴结转移组(40例)。采用Spearman相关分析探讨淋巴管入侵与膀胱癌复发和预后的相关性,应用Kaplan-Meier法描绘生存曲线,Cox比例危险度模型筛选影响膀胱癌患者预后的因素。结果:在72例膀胱癌组织中,淋巴管入侵的阳性率是48.6%(35/72),淋巴管入侵的阳性率随肿瘤分期和分级增加而显著升高(P0.05);淋巴结转移组的淋巴管入侵阳性率为68.8%(22/32),显著高于无淋巴结转移的32.5%(13/40)。淋巴管入侵与膀胱癌的临床分期、分级、淋巴结转移以及无淋巴结转移膀胱癌复发均显著相关(P0.05)。淋巴管入侵阴性的患者的五年总体生存率显著高于淋巴管入侵阳性者,淋巴管入侵是无淋巴结转移膀胱癌复发和预后不良的危险因素。结论:肿瘤淋巴管入侵与膀胱癌临床分期和淋巴结转移密切相关,并影响膀胱癌患者的总体生存率,可作为无淋巴结转移膀胱癌复发和预后的预测因素。     

miR-126 在膀胱癌患者尿液中的表达及临床意义

目的:探讨miR-126在膀胱癌患者尿液中的表达与临床病理特征的关系,评估miR-126的肿瘤标志物诊断价值。方法:收集48例初发膀胱尿路上皮癌患者与32例健康对照者晨尿,提取尿液总RNA,通过实时荧光定量PCR技术检测各样本中的miR-126的表达水平,并经受试者工作曲线(ROC)分析其诊断价值。结果:膀胱癌患者尿液中的miR-126表达水平相对健康对照组明显上调(P0.01),其表达水平在不同病理级别之间存在显著差异(P均0.05),且低级别组表达水平略高于高级别组,与肿瘤大小、数目以及淋巴转移也有一定的相关性(P0.05),而与患者的年龄、性别、TNM分期等均无相关性(P0.05)。通过ROC曲线分析尿液中miR-126诊断膀胱肿瘤的曲线下面积(AUC)为0.861,当最佳切点定在7.475时,miR-126诊断膀胱肿瘤的敏感性和特异性分别为75.0%、81.2%。结论:膀胱癌患者尿液中miR-126的表达差异能够反映病情进展程度,其表达水平对膀胱肿瘤的早期诊断及病情评估具有一定的价值。     

两种脱钙法植被鼠尾病理切片的比较

目的探讨制作大鼠尾巴标本石蜡切片的方法。方法采用盐酸脱钙液运用两种脱钙方法制作大鼠尾巴标本石蜡切片。结果两种方法制作的石蜡切片完整、无破碎,HE染色观察组织结构细胞形态完整,核浆分明,红蓝适度。结论两种方法都能制作理想大鼠尾巴标本石蜡切片,可保证病理诊断质量。     

Dermatoscopy and High Frequency Sonography: Two Useful Non-Invasive Methods to Increase Preoperative Diagnostic Accuracy in Pigmented Skin Lesions

Dermatoscopy and high frequency sonography have recently been combined to increase diagnostic preoperative accuracy in the treatment of pigmented skin lesions. In this monocentric study 80 patients with pigmented skin lesions were evaluated clinically, by dermatoscopy, and 20 MHz-sonography followed by dermatohistopathological evaluation; 39 malignant melanomas, 37 common nevi, 3 dysplastic nevi, and 1 nevus Spitz were diagnosed histologically. In 72 of the 80 cases (91.3%) dermatoscopical diagnoses were confirmed by histopathology, compared to only 79% correct clinical diagnoses. For the mere clinical diagnosis of melanoma sensitivity was 79%, specificity was 78% and diagnostic accuracy was 65%. All diagnostic values increased by dermatoscopy: sensitivity reached 90%, specificity was 93%, and diagnostic accuracy was 83%. In order to determine tumor thickness preoperatively tumor thickness was measured by 20 MHz sonography. The correlation of tumor thickness between histometric and sonographic results was determined for nevi (r = 0.93) and melanoma (r = 0.95); 74.3% of melanomas were diagnosed correctly within an 0.2 mm range. Regarding the clinical important limit of 1 mm tumor thickness, 87.2% were diagnosed in accordance with histometric evaluation. An increase of 18% in diagnostic accuracy by dermatoscopy and 87.2% of correctly diagnosed cases of tumor thickness of malignant melanoma by high frequency sonography clearly demonstrate that these methods should be considered standard procedures in the diagnosis of pigmented skin lesions and will facilitate the decision on necessary surgical treatment.     

Fine needle aspiration cytology of soft tissue tumors

OBJECTIVE: To review of the value of fine needle aspiration (FNA) cytology in the diagnosis of soft tissue tumors (STT). STUDY DESIGN: A review of the literature was coupled with the authors' experience with indications, diagnostic specificity and pitfalls; clinical information; and the final cytology report. RESULTS: Over the last few years, FNA has come to be considered a valuable tool in the management of STT in that it affords a specificity of > 90%. FNA is of particular value in any subcutaneous lesion > 5 cm, in all pediatric tumors and whenever direct incision biopsy is particularly contraindicated. Material from aspirates can be used to obtain cytologic smears for conventional staining, special pigment identification, histochemical techniques, cell blocks for paraffin embedding and ancillary techniques (immunocytochemistry, electron microscopy, and densitometric and cytogenetic analyses). The cytologic diagnosis, like its histologic counterpart, should be based on a correct evaluation of clinical data (age, localization, size, effect on bone, nerve and vessel involvement), radiologic information, cytologic findings (architectural pattern, cell and stroma characteristics) and results of special staining techniques. The final cytology report should place the tumor in one of three basic categories: benign, malignant, and inconclusive or undetermined. Wherever possible, a histopathologic diagnosis should also be provided, either based on purely cytologic criteria or aided by ancillary techniques. CONCLUSION: FNA does not present major complications and permits a swift, preliminary diagnosis in a large number of cases. The method is most effective when the aspiration is performed by an experienced pathologist.     

高频超声引导下导丝定位在不可触及乳腺包块切除术中的应用

目的:探讨高频超声引导下导丝定位在不可触及乳腺包块切除术中的应用价值。方法:回顾性分析90例临床不可触及但超声提示为乳腺包块的患者的临床资料,其中50例在高频超声引导乳腺病灶体表定位下行乳腺病灶切除术,40例在高频超声引导导丝定位下行乳腺病灶切除术。比较两组术前定位时间、手术时间、切除组织量/肿物组织量及术后并发症的发生情况、术后病理诊断及术后超声随访情况。结果:与体表定位组比较,导丝定位组定位时间显著延长(P0.05),手术时间明显缩短(P0.05),切除组织量/肿物组织量显著减小(P0.05)。体表定位组出现2例切口感染,5例血肿,两组不良反应的发生率相比差异无统计学意义(P0.05)。体表定位组良性48例(96.0%),恶性病灶2例(4.0%)。导丝定位组良性病灶36例(90.0%),恶性病灶4例(10.0%)。两组病理诊断为良/恶病灶的比例无统计学意义(P0.05)。术后超声随访6~12个月,病灶切除情况比较差异无统计学意义(P0.05)。结论:高频超声引导下导丝定位精确,可明显缩短手术时间,减少对正常乳腺组织的破坏,可作为行不可触及乳腺包块切除术的优先选择。