全数字化乳腺X线摄影诊断中青年乳腺癌的价值  

Diagnosis value of full-field digital mammography for breast cancer in young and middle-aged patients

作　　者：丁汉军[1] 郭媛[1] 汪珍穗[1] 纪昌焕[1] 

机构地区：[1]广州市第一人民医院放射科,广州510180

出　　处：《中华乳腺病杂志（电子版）》2012年第2期21-25,共5页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：广东省社会发展领域科技计划项目(93084)

摘　　要：目的探讨全数字化乳腺X线摄影(FFDM)诊断中青年乳腺癌的应用价值。方法收集2008年9月至2011年6月进行FFDM检查并经病理证实的中青年乳腺癌与良性乳腺病患者共375例。X线诊断标准采用美国放射学会推荐的乳腺报告和数据系统(BI-RADS):Ⅰ～Ⅲ级为良性,Ⅳ、Ⅴ级为恶性,并与病理结果对照;同时分析乳腺癌的X线表现。以致密型和多量腺体型为A组,少量腺体型和脂肪型为B组,两组灵敏度和特异度的比较采用χ2检验。结果乳腺癌的X线征象包括肿块或结节、钙化、片状致密影、结构紊乱等。FFDM诊断的灵敏度为82.0%(91/111),特异度为87.1%(230/264),阳性预测值为72.8%(91/125),阴性预测值为92.0%(230/250),正确率为85.6%(321/375)。A、B两组的FFDM诊断灵敏度、特异度分别为74.5%(35/47)和87.5%(56/64),84.4%(108/128)和89.7%(122/136),其差异无统计学意义(P>0.05)。结论全数字化乳腺X线摄影能及时发现乳腺病灶,对中青年乳腺癌具有较高的应用价值,X线诊断为BI-RADS-Ⅳ、Ⅴ级时建议行手术活组织检查。Objective To explore the diagnosis value of full-field digital mammography （FFDM） for breast cancer in young and middle-aged patients. Methods From September 2008 to June 2011, the data of 375 young and middle-aged patients with breast cancer or benign disease, confirmed with FFDM and pathologic diagnosis, were collected. The X-ray diagnosis followed the breast report and data system （BI-RADS） recommended by American College of Radiology： grade Ⅰ to Ⅲ regarded as benign, Ⅳ and V as malignant. The grading was compared with the pathological results. The X-ray features of breast cancer were analyzed. All cases were divided into 2 groups： group A including the patients with heterogeneously dense and extremely dense breast and group B including the patients with scattered fibroglandular densities and almost entirely fat breast tissue. The imaging diagnostic sensitivity and specificity of group A and B were analyzed by Chi-square test. Results The X-ray features of breast cancer included mass or nodule, calcification, flake shadow and structural disorder. The diagnostic sensitivity of FFDM was 82. 0% （91/111 ） , the specificity was 87.1% （230/ 264）, the positive predictive value was 72. 8% （91/125）, the negative predictive value was 92. 0% （230/ 250）, and the diagnose accuracy was 85.6% （321/375）. The imaging diagnostic sensitivity and specificity were 74. 5% （35/47）and 87.5% （56/64） in group A, and 84. 4% （ 108/128 ）and 89. 7% （122/136）in group B, respectively. There were no statistically significant differences between the two groups （P 〉 0. 05 ）. Conclusion Full-field digital mammography can find breast cancer lesion timely, and has a high diagnosis value for breast cancer in young and middle-aged patients. The grades Ⅳ and V are recommended for surgery.

关 键 词：乳腺肿瘤 乳房X线摄影术 计算机X线摄影 诊断 

分 类 号：R737.9[医药卫生—肿瘤]