触诊不清乳腺肿块超声引导定位切除的临床价值  

US-guided Preoperative Localization to Nonpalpable Breast Lesions

作　　者：朱庆莉[1] 张璟[1] 姜玉新[1] 刘赫[1] 孙强[2] 

机构地区：[1]中国医学科学院北京协和医院超声科,北京市100730 [2]中国医学科学院北京协和医院外科,北京市100730

出　　处：《中国超声医学杂志》2009年第12期1121-1123,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.30570529)资助

摘　　要：目的总结1998年～2008年北京协和医院超声引导术前定位切除的触诊不清的乳腺病变的特点,探讨该方法的临床价值。方法分析821例患者906个触诊不清的乳腺病灶的临床特点,对照手术病理结果评价超声诊断价值。结果定位切除的906个病灶中,良性814个(89.8%),恶性92个(10.2%)。乳腺癌病灶平均大小1.4cm(大小范围0.4～3.5cm)。84例乳腺癌中0期23例(27.4%),Ⅰ期45例(53.6%),Ⅱ期16例(19.0%)。超声引导定位病例数逐年增加,其中活检乳腺癌比例为2%～17.6%,平均为10.2%。超声术前诊断敏感性92.6%,特异性82.8%,准确性83.9%,阳性预测值40.8%,阴性预测值98.9%。结论临床触诊不清乳腺病变的超声引导术前定位切除活检操作方便,易于开展,对早期诊断、治疗乳腺癌有很大意义。Objective To evaluate the clinical value of US-guided localization for nonpalpalable breast lesions in Peking Union Medical College Hospital from 1998 to 2008. Methods The study included 906 nonpalpable breast lesions detected on US among 821 asymtomatic women who underwent US-guided localization preoperatively. The diagnostic value of US was evaluated by histology results as the golden standards. Results Among the 906 nonpalpable breast lesions, 814 （89.8%） were benign and 92 （10.2%） were malignant. The median size of US detected cancers was 1, 4cm （0. 4-3.5 cm） . The percentage of tumor stage 0, 1 and lI in 84 cancer patients was 27.4%, 53.6%, 19.0%, respectively. The number of localization procedure increased year by year. The cancer percentage of the open biopsy within these 10 years was 10. 2% in average, ranging from 2%-17.6%. The sensitivity, specificity, accuracy, positive predict value and negative predict value of US in the nonpalpable breast lesions were 92.6%, 82.8%, 83. 9%, 40. 8% and 98.90%, respectively. Conclusions US-guided preoperative localization to the nonpalpable breast lesions is a convenient and easy-operated procedures and helpful to the early detection and treatment of breast cancers.

关 键 词：超声引导定位 临床触诊不清的乳腺病变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]