数字化乳腺X线摄影观察年龄和乳腺密度与乳腺良恶性病变的关系  

Relationship between Age,Breast Density and the Risk of Breast Cancer and Benign Lesion with Digital Mammography

作　　者：杜铁桥[1] 王永利[1] 张超[1] 于盛会[1] 闫宇翔[1] 王新莲[1] 张亚杰[1] 张文奇[1] 

机构地区：[1]首都医科大学附属复兴医院放射科,北京100038

出　　处：《放射学实践》2009年第7期739-743,共5页Radiologic Practice

摘　　要：目的:探讨年龄因素和乳腺X线密度等级与乳腺癌和乳腺良性病变发病风险的相关性。方法:1621例乳腺X线受检者中,62例经手术病理证实为乳腺癌,192例经手术及其它影像手段证实为乳腺良性病变。按受检者年龄将患者分成≤30、31～40、41～50、51～60及≥61岁共5组,按乳腺百分密度分成<25%、25%～50%、51%～75%及>75%共4个等级进行统计分析。结果:乳腺密度在各年龄组之间差异有极显著性意义(P<0.001),随着年龄增长,乳腺密度逐渐减低,在41～50岁和51～60岁两组之间密度变化最显著(Z=-11.7,P<0.001)。62例乳腺癌在5个年龄组中按从低到高其检出率分别为2.1%、1.1%、3.3%、4.3%和10.9%,在4个密度等级组(从低到高)的检出率分别为17.7%、16.1%、21.0%和45.2%。多元逻辑回归分析结果显示,乳腺癌检出率随着年龄增长呈上升趋势(Waldχ2=40.9,P<0.001),随乳腺密度增长呈升高趋势(Waldχ2=17.6,P<0.001);年龄每增长10岁,乳腺癌检出率是前一低年龄段的3.0倍(OR值=3.0);密度每增加1个等级,癌检出率是前一低密度组的1.9倍(OR值=1.9)。乳腺良性病变随年龄增长呈上升趋势,但乳腺密度与良性病变检出率之间无相关性。结论:年龄及乳腺密度均为我国女性乳腺癌的重要危险因素,年龄因素对乳腺癌的影响更大,乳腺密度与乳腺癌发病的风险关系在绝经后的老年女性更突出。Objective： To study the relationship between factors including age, the qualitative classification of breast density on mammography and the risk of breast cancer and benign lesions. Methods： Of 1621 subjects having mammography, 62 patients had surgery and pathology proved breast cancer and 192 patients had surgery or other imaging modality proved benign breast lesion. All subjects were divided into 5 groups according to age, including ≤ 30,31 - 40,41 - 50,51 - 60 and ≥61 years old. According to the percentage of breast density on mammography, they were divided into 4 groups including breast density〈 25 %, 25 % -50 %, 51%- 75 % and - 75 %. Statistic analysis was undertaken. Results ： Significant statistic difference was seen between the breast density and various age groups. Breast density on mammography decreased with increase of age,which was the most significant in the groups with 41-50 and 51-60 years of age （Z=-11.7,P〈0.001）. The detection rate of 62 patients with breast cancer in the 5 age groups from young to old were 2.1% ,1.1% ,3.3% ,4.3% and 10.9%, respectively, and the detection rate of 4 breast density classes on mammography from low to high were 17.7%, 16.1 %, 21.0 % and 45.2 %, respectively. Multinomial logistic regressive analysis displayed that the trend of detecting breast cancer increased with age （Wald X2 = 40.9, P〈0. 001 ） as well as breast density （Wald X2 17.6, P〈0.001）. The detec tion rate of breast cancer was 3.0 times in every 10 years group from old to young in succession （OR value=3.0） and 1.9 times in the higher density group compared with the successive lower group （OR value= 1.9）. The detection rate of benign breast lesion ascended with increasing of age, but the mammographic density had no correlation with the detection rate of benign breast lesions. Conclusion： Age and breast density on mammography are important risk factors of breast cancer in Chinese women,especially the age factor. The relationship between the breast density on mammography

关 键 词：乳腺 乳腺X线摄影术 危险因子 

分 类 号：R737.9[医药卫生—肿瘤] R655.8[医药卫生—临床医学]