目的旨在探讨X线立体定位穿刺 活检对不可触及乳腺疾病组织病理结果的 准确性及其临床价值。方法 81例X线发 现乳腺异常而临床触诊阴性的患者，观 察病变X线表现及病变发生的部位，后行 X线立体三维定位穿刺活检。根据病理结 果，统计活检取得的阳性率、病理类型及 其所占的比例、获取的组织条数与病理阳 性率的关系。对活检病理结果与最终病理 结果(手术和复查)符合程度进行统计学分 析。结果 81例患者X线共发现84处病变， 表现微小钙化61例、腺体增厚16例、腺体 扭曲7例。病变位于外上象限47例。84处 病变(81例患者)均操作成功，穿刺活检成 功率为100%。阳性率为79.76%(67/84)， 其中乳腺癌0.75%(6/84)、良性病变 71.42%(60/84)、阴性率20%(17/84)。22 例行手术治疗的病例中，活检病理结果6 处乳腺癌与其手术后病理结果相符，58处 良性病变中14例手术治疗，病理结果相一 致。17处阴性者，有2处为术后病理为乳 腺增生病伴囊肿，穿刺活检病理结果与最 终手术病理结果作X2 检验比较，两者无统 计学意义(X2 =3.2，p值=0.74＞0.05)。其 余良性病变与阴性者，6个月以上复查， X线表现未见改变。结论 X线立体定位穿 刺活检对临床触诊阴性的乳腺病变定位准 确，活检阳性率高。为乳腺病变定性诊 断，特别是临床表现不明确的乳腺癌早期 检出有重要的价值。

Objectvie To evaluate the histopathological accuracy and clinical value of three-dimensional localizing aspiration biopsy by X-guide in diagnosing unpalpated breast diseases. Methods Manifestations of breast X-ray displayed abnormal in 81 patients and palpating were negative. X-ray manifestations of breast diseases and the locations were observed then three-dimensional localizing puncture by X-guide were done. According to the histopathology, the succeeding, positive, pathological types were accounted. The relation of number of tissue piece captured with pathological positive rate were analysed. The pathological results of aspiration biopsy were collated with finally pathological results (surgery and countercheck). Results Eighty-four focuses were detected in 81 patients by X-ray including 61 micro-calcific focuses, 16 glandulose incrassation, 7 glandulose distorting. Fourty-seven focuses located in outer-up quadrants. Operations were succeeding in all patients,The succeeding rate of puncture was 100%. Positive rate of aspiration biopsy accounted for 79.76%(67/84) including breast carcinoma accounted for 0.75%(6/84), benign disease was 71.42%(60/81), negative rate was 20%(17/84).In 22 operated cases, aspiration biopsy pathological results in 6 breast carcinomas was according to pathological results of surgery. Surgerical operation were performed in 14 cases of 58 benign focuses that both pathological results were consistent. Surgerical operation were performed in 2 cases of 17 negative that pathological results were breast hyperplasia with cyst. X2 test were done between cases of histopathological types from aspiration biopsy and ones from operation that had not statistical significance (X2 =3.2,p=0.74＞0.05).X-rays were performed again in the rest patiens of benign focuses and negative by puncture after more 6 months which manifestations of X-rays had no changed. Conclusion Threedimensional localizing aspiration biopsy by X-guide could correctly localized, positive rate was high and negative rate was low to breast diseases which palpating were negative. It was a valuable means for qualitation of breast disease, specially breast carcinaoma with unconspicuous symptom.