乳腺癌筛查模式的探讨  

To Investigate the Screening Model of Breast Cancer

作　　者：封任冬[1] 汪华 丁莹莹[3] 李润明[4] 王瑞兰[5] 曹志坚[6] 高琨[7] 

机构地区：[1]玉溪市人民医院(昆明医科大学第六附属医院)放射科,653100 [2]玉溪市红塔区妇幼保健院,653100 [3]云南省肿瘤医院(昆明医科大学第三附属医院)放射科 [4]玉溪市人民医院(昆明医科大学第六附属医院)乳腺外科,653100 [5]玉溪市人民医院(昆明医科大学第六附属医院)超声科,653100 [6]昆明市妇幼保健院放射科,650031 [7]玉溪市人民医院(昆明医科大学第六附属医院)病理科,653100

出　　处：《临床放射学杂志》2016年第1期36-40,共5页Journal of Clinical Radiology

基　　金：2008年中央财政转移支出乳腺癌筛查项目

摘　　要：目的探索适合中国妇女生物学特性的乳腺癌筛查模式。方法对2000例乳腺触诊阳性与可疑者分别采用以乳腺X线摄影为主、超声检查为辅(模式一)和以超声检查为主、乳腺X线检查为辅(模式二)的两种筛查模式筛查,分析两种筛查方法的乳腺癌检出率、召回率、特异度、敏感度及阳性预测值,并与手术病理诊断结果对照和进行统计学处理。结果模式一:真阳性6例,真阴性1920例;假阳性74例,假阴性0。乳腺癌检出率为3%,召回率8.5%,阳性预测值12%,特异度96.3%,敏感度100%。模式二:真阳性3例,真阴性1940例;假阳性54例,假阴性3例。乳腺癌检出率为1.5%,召回率9.3%,阳性预测值5.3%,特异度97.3%,敏感度50%。两者比较,模式一敏感度、阳性预测值、肿瘤大小、召回率均优于模式二,敏感度及阳性预测值比较采用卡方检验,P﹤0.05为差异有统计学意义。结论以乳腺X线检查为主,超声辅助的筛查模式是乳腺癌筛查的最佳模式。Objective To explore the biological characteristics of Chinese women breast cancer screening model Methods For 2000 cases of mammary positive hand diagnosis the screening test was performed as follows ： model a： breast X-ray radiography as a main screening modality and ultrasonography as assistant , and model b： breast ultrasonography as a main screening modality and x. ray as assistant, analysis of the two methods of screening for breast cancer detection, recall, sensitivity and positive predictive value, and comparing the results with the surgical pathology results, performing statistical analysis Results Model a： true positive 6 cases, true negative 1920 cases; false positives 74 cases, false negative number 0. Breast cancer detection rate was 3%, the recall rate was 3% , positive predictive value was 12% , specificity degree was 96.3% and sensitivity 100%. Model b： true positive 3 cases, true negative 1940 cases; false positive results 54 cases, false negative 3 cases. Breast cancer detection rate was 1.5% , the recall rate was 1.5% , positive predictive value 5.3%, specificity degree 97.3% and sensitivity 50%. By comparison the resuhs of two models, model a sensitivity, positive predictive value, tumor size and the recall rate were better than the model . for comparing the sensitivity and positive predictive value, chi-square test was used, P 〈0. 05, the difference was statistically significant. Conclusion X-ray mammography as a main screening modality and altrasonography as assistant is the best model for breast cancer screening.

关 键 词：乳腺癌 X线 超声 筛查模式 

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