探讨3D-CPA在乳腺良恶性肿块鉴别诊断及血管生成活性的应用价值  

Application Value of 3D-CPA in Differential Diagnosis and Angiogenic Activity of Breast Benign and Malignant Masses

作　　者：黄继才 陈保利 王小金 何琼瑛 黎明瑜 HUANG Ji-cai;CHEN Bao-li;WANG Xiao-jin(Lunjiao Hospital,Foshan,Guangdong,528308,China)

机构地区：[1]佛山市顺德区伦教医院,广东佛山528308

出　　处：《黑龙江医学》2020年第8期1096-1098,共3页Heilongjiang Medical Journal

摘　　要：目的探讨三维多普勒能量图(3D-CPA)在乳腺良恶性肿块鉴别诊断及血管生成活性的应用价值。方法回顾性分析佛山市顺德区伦教医院于2018年1月—2019年11月间就诊的77例乳腺肿块患者临床资料,经穿刺活检或手术病理检查共检出83个肿块,根据穿刺活检或手术病理检出结果分为良性组(n=52)与恶性组(n=31)。所有患者均行3D-CPA诊断,以Adler半定量法分析血流程度,将Ⅲ级作为乳腺恶性肿块鉴别标准,对比两组血流分级,并以穿刺活检或手术病理检查结果为"金标准",分析3D-CPA鉴别恶性肿块的价值,同时统计两组患者血管内皮生长因子(VEGF)、病理组织学中免疫组化染色阳性的微血管密度(MVD)检测结果,对比两组VEGF水平与MVD计数。结果良性组血流分级中0级、Ⅰ级、Ⅱ级较恶性组高,Ⅲ级较恶性组低,差异有统计学意义(P<0.05)。依据穿刺活检或手术病理诊断"金标准",3D-CPA诊断灵敏度为87.10%,特异度为96.15%,准确度为92.77%,阳性预测值为93.10%,阴性预测值为92.59%。良性组VEGF水平、MVD计数均较恶性组低,差异有统计学意义(P<0.05)。结论3D-CPA可有效鉴别乳腺良恶性肿块,为临床诊断提供参考,且恶性肿块多呈高血管生成活性状态。Objective To explore the application value of 3D-CPA in the differential diagnosis and angiogenesis activity of breast benign and malignant masses.Methods The clinical data of 77 patients with breast masses from January,2018 to November,2019 in the hospital were analyzed retrospectively.83 masses were detected by biopsy or surgical pathology.According to the results of biopsy or surgical pathology,they were divided into benign group(n=52 masses)and malignant group(n=31 masses).All patients were diagnosed by 3D-CPA.Adler’s semi quantitative method was used to analyze the degree of blood flow.Grade III was used as the differentiation standard of malignant breast masses.The blood flow grades of the two groups were compared.The results of biopsy or surgical pathology were used as the"gold standard"to analyze the value of 3D-CPA in the differentiation of malignant breast masses.Meanwhile,VEGF and immunohistochemical staining in histopathology of the two groups were counted.The results of MVD were compared with VEGF level and MVD count.Results The blood flow grade of benign group was higher than that of malignant group in grade 0,gradeⅠand gradeⅡ,and lower in gradeⅢ,the difference was statistically significant(P<0.05).According to the"gold standard"of biopsy or operation pathology,the diagnostic sensitivity of 3D-CPA was 87.10%,the specificity was 96.15%,the accuracy was 92.77%,the positive predictive value was 93.10%,and the negative predictive value was92.59%.The level of VEGF and MVD in benign group were lower than those in malignant group(P<0.05).Conclusion 3D-CPA can effectively distinguish benign and malignant breast masses,and provide a reference for clinical diagnosis,and the malignant masses are mostly in the state of high angiogenesis activity.

关 键 词：乳腺肿块 三维多普勒能量图 良恶性鉴别 血管生成活性 

分 类 号：R737.9[医药卫生—肿瘤]