探讨横滨报告系统在乳腺肿块空芯针穿刺组织印片快速现场评价（ROSE）中的应用价值，评估基于该报告系统的ROSE分类情况开展患者分流管理的临床意义。

根据纳入、排除标准，纳入2024年1月至2025年12月在宝鸡市中心医院行超声引导下乳腺肿块空芯针穿刺活检的1 475例患者资料进行前瞻性研究。穿刺标本同时制备组织印片行ROSE，采用国际细胞学学会横滨报告系统作为分类标准完成ROSE判读，结果分为良性病变、非典型病变、疑为恶性肿瘤、恶性肿瘤。以组织学诊断为金标准，对比分析基于横滨报告系统的ROSE分类结果与组织学诊断的符合情况。采用Kappa一致性检验评估ROSE对乳腺肿块的诊断效能，并根据分类结果指导患者分流。

1 475例标本中，基于横滨报告系统的ROSE分类结果：良性病变770例，非典型病变74例，疑为恶性肿瘤43例，恶性肿瘤588例；其与组织学诊断准确度分别为99.5%（766/770）、55.4%（41/74）、93.0%（40/43）、100%（588/588）。基于横滨报告系统的ROSE分类对比组织学诊断金标准的敏感度和特异度分别为94.58%（628/664）和99.63%（808/811），准确度为97.36%（1 436/1 475），阳性预测值和阴性预测值分别为99.52%（628/631）和95.73%（808/844）。乳腺肿块采用基于横滨报告系统的ROSE分类结果与组织学诊断一致性较好（κ=0.946，P<0.05）。基于横滨报告系统的ROSE分类为良性病变的770例患者均行日间手术，术中冰冻病理结果提示3例为恶性、1例为韧带样纤维瘤病的患者行扩大手术，与ROSE结果相符的766例患者次日出院；ROSE分类为非典型病变、疑为恶性肿瘤、恶性肿瘤均等待次日穿刺组织学病理结果，组织学诊断为良性病变的患者行微创手术，诊断为交界性肿瘤的患者行扩大手术，诊断为恶性肿瘤的患者行新辅助治疗或改良根治术或保留乳房手术。

横滨报告系统可应用于乳腺肿块空芯针穿刺组织印片ROSE中，分类为良性病变、疑为恶性肿瘤及恶性肿瘤者与组织学诊断准确度较高，对评估乳腺肿块性质具有较高的诊断效能，有助于优化乳腺肿块患者的诊疗流程。

To explore the application value of the Yokohama reporting system in rapid on-site evaluation (ROSE) of touch imprints from core-needle biopsy (CNB) of breast masses, and to evaluate the clinical significance of patient triage management based on ROSE classification according to this reporting system.

According to the inclusion and exclusion criteria, the data of 1 475 patients who underwent ultrasound-guided CNB for breast masses at the Baoji Central Hospital from January 2024 to December 2025 were enrolled in this prospective study. Touch imprints were simultaneously prepared from biopsy specimens for ROSE. ROSE interpretation was performed with the Yokohama reporting system by the International Academy of Cytology as the classification standard, and the results were divided into benign lesion, atypical lesion, suspicious for malignancy and malignant tumour. Using histological diagnosis as the gold standard, the concordance between ROSE classification results based on the Yokohama reporting system and histological diagnosis was compared and analysed. The Kappa consistency test was adopted to evaluate the diagnostic efficacy of ROSE for breast masses, and patient triage was guided according to the classification results.

Among the 1 475 specimens, ROSE classifications based on the Yokohama reporting system showed 770 benign lesions, 74 atypical lesions, 43 suspicious malignancies and 588 malignant tumours. The diagnostic accuracy compared with histological diagnosis was 99.5% (766/770), 55.4% (41/74), 93.0% (40/43) and 100% (588/588), respectively. The sensitivity, specificity and overall accuracy of ROSE classification based on the Yokohama reporting system against the histopathological gold standard were 94.58% (628/664), 99.63% (808/811) and 97.36% (1 436/1 475), respectively. The positive predictive value and negative predictive value were 99.52% (628/631) and 95.73% (808/844). The ROSE classification of breast masses had good consistency with histological diagnosis (κ=0.946, P<0.05). All 770 patients with ROSE classification of benign lesion received day-case surgery. Intraoperative frozen pathology revealed 3 cases of malignancy and 1 case of desmoid fibromatosis, for which extended surgery was subsequently performed. The remaining 766 patients consistent with ROSE results were discharged on the next day. Patients with ROSE results of atypical lesion, suspicious malignancy and malignant tumour waited for the final histological report on the following day. Patients with histologically confirmed benign lesions underwent minimally invasive surgery; patients with borderline tumours received extended surgery; patients with malignant tumours received neoadjuvant therapy, modified radical mastectomy or breast-conserving surgery.

The Yokohama reporting system can be applied to ROSE of touch imprints from CNB of breast masses. The categories of benign lesion, suspicious malignancy and malignant tumour demonstrate high concordance with histological diagnosis. This system exhibits high diagnostic efficacy in evaluating the nature of breast masses and helps optimise the diagnosis and treatment workflow for patients with breast masses.