对乳腺增生患者直径较小乳腺结节的定期随访结果的回顾性分析  

Retrospective analysis of regular follow-up results of mammary gland hyperplasia patients with small diameter mammary nodules

作　　者：赵海军[1] 王娟[2] 王全乐[1] 叶学奎 尹丽娜[1] 杜倩倩[1] 李莹[1] 李静亚[1] 

机构地区：[1]石家庄市第四医院,050011 [2]河北省人民医院,石家庄050000

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第5期608-612,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：河北省卫生计生委医学科学重点研究计划项目(20150888)~~

摘　　要：目的探讨临床对于乳腺增生（MGH）患者经彩色多普勒超声筛查发现的直径〈1cm乳腺结节的变化趋势。方法选择2010年3～12月于石家庄市第四医院经彩色多普勒超声乳腺疾病筛查发现乳腺结节直径〈1cm的1309例MGH患者为研究对象。采用回顾性分析方法分析其5年（2011—2015年）定期随访结果，包括乳腺结节直径、影像学评分、临床触诊评分、疼痛评分，以及手术率、乳腺非典型增生与癌变率，并进行统计学分析。结果①对乳腺结节直径G1cm的1309例MGH患者从确诊至定期随访1、2、3、4、5年时，乳腺结节影像学评分保持稳定者分别为1289、1174、1102、928、741例，评分增高者分别为20、119、164、301、413例，接受手术治疗者分别为4、12、27、37、75例，术后诊断为乳腺腺病者分别为4、10、17、24、45例，乳腺非典型增生者分别为0、2、8、11、26例，乳腺癌变者分别为0、0、2、2、4例。②本研究1309例MGH患者从确诊至定期随访1、2、3、4、5年时，乳腺结节直径、影像学评分分别比较，差异均有统计学意义（F=2704．87，PG0．001；F=200．03，P〈0．001），随着随访时间的延长，乳腺结节直径及影像学评分均升高；但是其乳腺结节的疼痛评分及临床触诊评分分别比较，差异均无统计学意义（F=2．32，P=0．054；F=1．98，P=0．094）。③本研究1309例MGH患者的手术率及乳腺非典型增生率分别比较，差异均有统计学意义（χ2=1097，71，P《0．001；χ2=48．45，PG0．001）。Cochran—Armitage趋势检验结果显示，随着随访时间的延长，乳腺结节患者手术率及乳腺非典型增生率均逐渐增加（Z=9．913，P〈0．001；Z=6．488，P〈0．001）。5年随访期内，本研究1309例MGH患者乳腺结节癌变率比较，差异无统计学意义（χ2=7．41，P=0．091）。结论随着时间延长，MGH患者的直径〈1cm乳腺结节有恶性病变风险，�Objective To explore the necessity of clinical intervention for diameter 〈1 cm mammary nodules screened by breast color Doppler ultrasound in mammary gland hyperplasia （MGH） patients. Methods From March to December 2010, a total of 1 309 cases of patients with diameter 1 cm mammary nodules screened by breast color Doppler ultrasound in the Fourth Hospital of Shijiazhuang were selected as research subjects. The regular follow-up results of MGH patients by 5 years （2011 to 2015）, such as the diameter, imaging score, clinical palpation score and pain score of mammary nodules, and rates of surgical treatment, incidence of atypical hyperplasia and breast cancer of MGH patients were analyzed by retrospective analysis method and statistical methods. Results （1）The regular follow-up results of 1 309 cases of MGH patients by 1-, 2-, 3-, 4- and 5-year showed that, 1 289, 1 174, 1 102, 928 and 741 cases of patients＇s mammary nodules imaging scores remained stable respectively, and 20, 119, 164, 301 and 413 eases of patientsr mammary nodules imaging scores increased respectively, of which 4, 10, 17, 24 and 45 cases underwent surgical treatment respectively, and 4, 10, 17, 24 and 45 eases were diagnosed as breast adenosis by postoperative pathology diagnosis respectively, and 0, 2, 8, 11 and 26 eases were diagnosed as atypical hyperplasia respectively, and 0, 0, 2, 2 and 4 eases were diagnosed as breast cancer respectively. ~）There were statistical differences in the diameters and imaging scores of mammary nodules among 1 309 cases of MGH patients from 2011 to 2015 （F=2 704. 87, P〈0.001; F= 200.03, P〈0. 001）. With the extension of follow-up time, the diameters and imaging scores of mammary nodules increased. But there were no statistical differences in the pain scores and clinical palpation scores of mammary nodules among 1 309 cases of MGH patients from 2011 to 2015 （F= 2.32, P=0. 054, F=I. 98, P=0. 094）. （2）There were statistical differences in the surgical rate and the incidence of atypic

关 键 词：乳腺增生 乳腺结节 恶性病变风险 随访研究 临床干预 

分 类 号：R655.8[医药卫生—外科学]