乳腺X线和超声检查对T1及Tis期乳腺癌诊断效能的比较  

Comparison of efficacy for mammography versus ultrasonography in stages T1 and Tis breast cancer

作　　者：王菊[1] 刘佩芳[1] 李军楠[1] 青春[1] 赵玉梅[1] 邵真真[1] 

机构地区：[1]天津市肿瘤医院乳腺影像诊断科,300060

出　　处：《中华医学杂志》2015年第1期34-36,共3页National Medical Journal of China

摘　　要：目的 比较乳腺X线和超声检查对T1及Tis期乳腺癌的诊断效能,为探索适合中国北方女性乳腺癌筛查模式提供循证医学信息.方法 收集2011年7月至2013年7月就诊于天津市肿瘤医院具备完整的乳腺X线及超声检查资料T1及Tis期乳腺癌患者1 630例,采用x2检验比较两种影像学方法对乳腺癌的检出率和诊断准确率.结果 1 630例患者共1 665个病变,乳腺X线和超声检查均检出的病变共1 559个.在病变检出率方面,对于脂肪型或少量纤维腺体型乳腺,X线检查对病变检出率明显高于超声检查（P＜0.05）;对于多量纤维腺体型乳腺,两者对病变检出率差异无统计学意义;对于致密型乳腺,超声检查对病变检出率则明显高于X线检查（P＜0.05）.在病变诊断准确率方面,对于脂肪型及少量纤维腺体型乳腺,本组资料显示超声检查对病变的诊断准确率相同或低于X线;对于多量纤维腺体和致密型乳腺,超声检查对病变的诊断准确率高于X线检查,但各组间比较差异均无统计学意义（均P＞0.05）.另外,基于X线检查将病变类型分为肿块型和非肿块型病变,随着纤维腺体密度升高,非肿块型病变所占比例升高,肿块型病变比例降低.结论 乳腺X线检查对于纤维腺体量较少的T1及Tis期乳腺癌的病变检出率及诊断准确率较高,而超声检查对于纤维腺体量较多的T1及Tis期乳腺癌的病变检出率及诊断准确率较高.基于X线的病变类型进行分组,病变类型与纤维腺体类型之间存在一定的相关性.Objective To compare the efficacy of mammography versus ultrasonography in detecting stages T1 and Tis breast cancer.Methods Mammography and ultrasonograhpy data were collected for 1 630 stages T1 and Tis breast cancer from July 2011 to July 2013.Chi-square test was used to analyze the detection rate and diagnostic rate of two methods.Results Among 1 630 patients with 1 665 focus,1 559 focus were detected by both methods.In term of detection rate,mammography had a higher rate in mostly fatty and scattered fibroglandular breast while ultrasonography offered advantages in extremely dense breast.And statistical significance existed among these groups （P ＜ 0.05）.In heterogeneously dense group,the detection rate of two methods had no statistical significance （P ＞ 0.05）.In term of diagnostic rate,mammography had a higher diagnostic rate in mostly fatty and scattered fibroglandular breast.On the contrary,ultrasonography was superior to mammography in heterogeneously and extremely dense breast.No statistical significance existed among these groups （P ＞ 0.05）.Furthermore the focus were classified into mass and non-mass types based on mammographic images.As the volume of fibroglandular tissue increased,the amount of mass type focus increased while that of non-mass type focus decreased.Conclusion For stages T1 and Tis breast cancer,mammography has higher detection and diagnostic rates in mostly fatty and scattered fibroglandular breast while ultrasonography is better for heterogeneously and extremely dense breast.There are some correlations between fibroglandular and focus types based on mammographic images.

关 键 词：乳腺癌 T1和Tis期 乳腺X线 超声 诊断效能 

分 类 号：R737.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.1