高频彩超与钼靶X线在不同年龄乳腺癌初诊中的对比研究  

Comparative Study on High-frequency Color Doppler Ultrasonography and Mammography for the Primary Diagnosis of Breast Cancer in Different Ages

作　　者：赵丽娟[1] 徐卫云[1] 张晓红[1] 张珍[1] 唐卓葳[1] 张靖[1] 

机构地区：[1]绵阳市中心医院乳腺外科,四川绵阳621000

出　　处：《中国医药指南》2016年第3期14-15,共2页Guide of China Medicine

摘　　要：目的探讨高频彩超与钼靶X线在乳腺癌不同年龄初诊患者中的应用价值。方法随机抽取我科2012年1月至2014年8月资料完整的280例乳腺癌患者。高频彩超及X线摄影采用美国放射学会提出的乳腺影像报告和数据系统（BI-RADS）2003年第4版标准,进行规范化的乳腺评估分类,结合临床病检资料进行分析。结果联合检查准确率为92.86%,高频彩超准确率（87.86%）显著低于联合检查（χ~2=4.017,P=0.045）,钼靶X线准确率（78.93%）显著低于高频彩超（χ~2=8.059,P=0.005）、联合检查（χ~2=22.415,P=0.000）。按年龄分层分析发现,在〈45岁患者中高频彩超准确率明显优于钼靶X线,二者之间差异具有统计学意义,P〈0.01。在≥45岁患者中高频彩超准确率与钼靶X线无明显统计学差异,P〉0.05。结论临床触诊后,〈45岁妇女优选彩超,≥45岁妇女优选钼靶作为初筛手段,对初筛阴性的高危患者再联合钼靶或彩超更经济实用,符合中国国情,值得临床推广应用。Objective To discuss the application value of high-frequency color Doppler ultrasonography and mammography for the primary diagnosis of breast cancer in different ages. Methods 280 cases of breast cancer patients with complete data who came to our department from January 2012 to August 2014 were selected randomly. The primary diagnosis results are formally classified by combining the data of ultrasonography and mammography with clinical pathological examination. The ultrasonography and mammography data follow the 4th Edition of BI-RADS（breast imaging reporting and data system） proposed by ACR（american college of radiology）. Results The accuracy of combination examination was 92.86%. The accuracy of ultrasonograph y（87.86%）was significantly lower than combination examination（χ~2=4.017, P =0.045）, and the accuracy of mammography（78.93%） was significantly lower than that of ultrasonography（χ~2=8.059, P =0.005） and combination examination（χ~2=22.415, P =0.000）. According to the age stratified analysis, the accuracy of patients younger than 45 years diagnosed with ultrasonography is obviously superior to that of mammography, with statistically significant difference, P〈0.01. In contrast, for patients older than 45 years, the accuracy of ultrasonography does not have obvious statistical difference with mammography, P〈0.05. Conclusion After clinical palpation, it is better to select ultrasonography for patients younger than 45 years. Patients older than 45 years prefer mammography as a preliminary screening. The high-risk patients with negative mammography or ultrasonography screening results are recommended to accept combination examination. This is more economical and practical, meeting with China＇s national conditions, worthy of clinical application.

关 键 词：乳腺癌 彩超 乳房X线摄影术 

分 类 号：R737.9[医药卫生—肿瘤]