上海社区8234名女性乳腺癌筛查首轮影像结果分析  

The first round imaging screening of breast cancer in Shanghai community： primary results in 8234 patients

作　　者：丁建辉[1] 彭卫军[1] 蒋朝霞[1] 柳光宇[2] 季亚婕[2] 郑晓静[1] 胡丹婷[1] 吴坚[1] 常才[3] 曾炜[3] 

机构地区：[1]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院放射诊断科,200032 [2]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院外科,200032 [3]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院超声科,200032

出　　处：《中华放射学杂志》2013年第8期681-684,共4页Chinese Journal of Radiology

摘　　要：目的探讨乳腺X线、超声两种筛查方法对社区女性乳腺癌检出的价值。方法8234名社区妇女参加乳腺影像初次筛查，包括乳腺X线检查（8232名）以及超声检查（8231名），分析影像筛查的召回率、活检率、癌检出率，采用行X列卡方检验或Fisher精确检验比较乳腺x线摄影、超声以及两种方法对乳腺癌检出的敏感度。结果256名妇女被召回，召回率3．11％（256／8234），其中117名分别行穿刺活检（42名）或手术（75名），活检率1．42％（117／8234）。X线结合超声共检出乳腺癌33例，癌检出率0．40％（33／8234），筛查癌中早期癌比例为51．5％（17／33），另发现间隙期癌3例，筛查癌占初筛人群0．44％（36／8234）。x线结合超声检出乳腺癌的敏感度91．7％（33／36），乳腺X线检出乳腺癌31例，敏感度86．1％（31／36），乳腺超声检出乳腺癌20例，敏感度55．6％（20／36），X线加超声及单用乳腺x线较乳腺超声能筛查出更多的乳腺癌患者，敏感度的差异有统计学意义（X2值分别为12．0834、8．1345，P值均〈0．01）。乳腺X线摄影检出乳腺癌的阳性预测值为10．43％（31／297）。结论乳腺X线摄影较超声能筛查出更多的乳腺癌，两种影像筛查方法组合可能更适合我国城市社区妇女乳腺癌筛查。Objective To discuss the significance of two screening methods （mammography and ultrasonography） for detection of breast cancer in Chinese urban community. Methods The first round imaging screening of breast cancer were performed in 8234 women in shanghai community. The screening methods include mammography （8232 patients） and uhrasonography （8231 patients）. The rate of recall, biopsy, cancer detection of the imaging screening were analyzed. Sensitivity of three methods （ mammography, uhrasonography, mammography with ultrasonography ） were compared. Chi-square test or Fisher exact test were used for the statistical analysis. Results Two hundred and fifty six women were recalled in the screening,and the recall rates were 3.11% （256/8234）. One hundred and seventeen of 256 women underwent biopsy,and the biopsy rates were 1.42% （117/8234）. Thirty three breast cancers were detected by mammography with uhrasonography, and the cancer detection rate were 0.40% （33/8234）. Seventeen of 33 patients had early stage breast cancer （51.5%, 17/33 ）. In addition, 3 interval cancers were found at screening. Thirty one breast cancers were detected by mammography and only 20 of them were detected by ultrasonography. The sensitivity of three methods （mammography, ultrasonography, mammography with ultrasonography ） for detecting breast cancer were 91.7% （33/36）,86. 1% （31/36）and 55.6% （20/36） respectively. There were statistical differences of sensitivity among three screening methods. Mammography with ultrasonography and mammography only can detect more breast cancer than uhrasonography （X2 = 12. 0834,8. 1345 ; P 〈 0. 01 ）. PPV1 of mammography were 10. 43% （ 31/297 ）. Conclusion Although mammography can detect more breast cancer than ultrasonography, combination of two kinds of screeningmethods may be more suitable for screening for breast cancer in women in Chinese urban communities.

关 键 词：乳腺肿瘤 乳腺X线摄影术 超声 

分 类 号：R737.9[医药卫生—肿瘤]