乳腺超声弹性成像联合血清MCP-1含量测定在乳腺良恶性肿瘤鉴别诊断中的作用  

Compression elastography and serum MCP-1 level in differential diagnosis of benign and malignant breast tumors

作　　者：吕明丽[1] 杨钰[1] 曾敏[1] 牛建梅[1] LV Mingli YANG Yu ZENG Min NIU Jianmei(Department of Ultrasonography, International Peace Maternity ＆ Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, Chin)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院超声科,上海200030

出　　处：《肿瘤影像学》2017年第4期289-294,共6页Oncoradiology

基　　金：中国福利会国际和平妇幼保健院优秀青年培育计划;国家自然科学基金项目(No:81402386)

摘　　要：目的:探讨乳腺超声弹性成像联合血清人单核细胞趋化因子1(monocyte chemoattractant protein 1,MCP-1)含量测定在乳腺良恶性肿瘤鉴别诊断中的作用。方法:选取2015年1—6月就诊于上海交通大学医学院附属国际和平妇幼保健院乳腺科的患者60例,行常规二维超声和压迫式声弹性成像,计算弹性应变率(strain ratio,SR)。Luminex液相芯片测定患者术前血清MCP-1水平。以病理结果为金标准,评价上述两种方法单独及联用的诊断效能。结果:乳腺超声弹性在截断点为4.87时,灵敏度为83.33%,特异度为70.81%。血清MCP-1测定截断点为45.6 pg/m L时,灵敏度为100.0%,特异度为91.7%。两种方法联用后其受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积为0.99,与单独使用乳腺弹性成像相比,差异有统计学意义(P=0.002 5)。乳腺恶性肿瘤弹性成像SR值与血清MCP-1水平呈正相关(r=0.732,P<0.01)。结论:乳腺超声弹性与血清MCP-1联用可大大提高对乳腺良恶性肿瘤的鉴别诊断效能,具有一定的临床应用价值。Objective： To evaluate the roles of compression elastography and serum monocyte chemoattractant protein 1 （MCP-1） level in the differential diagnosis of begin and malignant breast tumors. Methods： A total of 60 patients with liver lesions were selected from International Peace Maternity ＆ Child Health Hospital, Shanghai Jiao Tong University School of Medicine from January to June 2o16. They underwent the conventional ultrasound and compression elastography examinations and strain ratio （SR） was obtained. Luminex liquid chip technology was used to analyze the level of MCP-1 in serum. The two methods alone and in combination were applied in this study. The pathological results were set as the gold standard and used to evaluate the diagnosis efficiency in differential diagnosing benign and malignant breast tumors. Results： With the cutoff value of SR at 4.87, the sensitivity and specificity of compression elastography in the diagnosis of malignant breast tumor were 83.33% and 70.81%. With the cutoff value of serum MCP-1 level at 45.6 pg/mL, the sensitivity and specificity of compression elastography in the diagnosis of malignant breast tumor were 100.0% and 91.7%. When the two methods were combined, the area under receiver operating characteristic （ROC） curve was 0.99, with statistical difference in comparison with compression elastography alone （P=-0.002 5）. Further correlation analysis showed that there was apositively correlation between SR value and MCP-1 level in serum （r=0.732, P〈0.000）. Conclusion： The combination of compression elastography and serum MCP-1 level is useful for the differential diagnosis of benign and malignant breast tumors.

关 键 词：乳腺肿瘤 压迫式弹性成像 单核细胞趋化因子1 

分 类 号：R445.1[医药卫生—影像医学与核医学]