全数字化乳腺钼靶单独与联合磁共振诊断乳腺导管原位癌的准确度和成本效益分析  

Accuracy and cost-effectiveness of full-digital mammography alone and combined with magnetic resonance imaging in the diagnosis of breast ductal carcinoma in situ

作　　者：郭胜春 GUO Shengchun(Department of Oncology,People's Hospital of Wuzhou City,Guangxi Wuzhou 543002,China)

机构地区：[1]梧州市人民医院肿瘤科,广西梧州543002

出　　处：《现代肿瘤医学》2021年第1期120-123,共4页Journal of Modern Oncology

摘　　要：目的:比较全数字化乳腺钼靶单独与联合磁共振诊断乳腺导管原位癌(DCIS)的准确度和成本效益,为DCIS早期筛查方案的选择提供参考依据。方法:回顾性分析我院2014年8月至2018年8月经病理检查确诊的84例DCIS患者的临床资料,整理其术前全数字化乳腺钼靶、磁共振成像(MRI)表现,分析钼靶、MRI及钼靶联合MRI诊断DCIS的准确度;以成本/准确率计算三种模式诊断DCIS的正确检出费用,即成本效益。结果:全数字化乳腺钼靶X线、MRI单独诊断DCIS的准确率分别为77.38%、85.71%,二者联合诊断DCIS的准确率为91.67%(77/84),联合诊断的准确率高于单独诊断(P<0.05),MRI单独诊断DCIS的准确率与全数字化乳腺钼靶X线单独诊断比较,差异无统计学意义(P>0.05)。全数字化乳腺钼靶X线诊断DCIS的成本效益比最低,其次为MRI,联合诊断的成本效益比最高,差异有统计学意义(P<0.05)。结论:对于多数疑似DCIS患者而言,全数字化钼靶X线检查即可满足临床早期诊断需求,高危患者可考虑联合MRI检查。Objective:To compare the accuracy and cost-effectiveness of full-digital mammography and combined magnetic resonance imaging in the diagnosis of breast ductal carcinoma in situ(DCIS),so as to provide reference for the selection of early screening schemes for DCIS.Methods:The clinical data of 84 patients with DCIS diagnosed by pathological examination in our hospital from August 2014 to August 2018 were retrospectively analyzed.The preoperative full digital mammography and magnetic resonance imaging(MRI)findings were sorted out.The accuracy of DCIS diagnosed by molybdenum target,magnetic resonance imaging and molybdenum target combined with magnetic resonance imaging was analyzed.Cost/accuracy was used to calculate the correct detection cost of DCIS diagnosed by three modes,i.e.cost-effectiveness.Results:The diagnostic accuracy of DCIS by digital mammography and MRI alone was 77.38%and 85.71%,respectively.The combined diagnostic accuracy of DCIS was 91.67%(77/84).The combined diagnostic accuracy was higher than that by single diagnosis(P<0.05).There was no significant difference between the diagnostic accuracy of DCIS by MRI alone and that by digital mammography alone(P>0.05).The cost-benefit ratio of DCIS diagnosed by full digital mammography was the lowest,followed by MRI,and the cost-benefit ratio of combined diagnosis was the highest,with statistical significance(P<0.05).Conclusion:For most suspected DCIS patients,full digital mammography can meet the needs of early clinical diagnosis,and high-risk patients can consider joint MRI examination.

关 键 词：全数字化乳腺钼靶 磁共振 乳腺导管原位癌 成本效益 

分 类 号：R737.9[医药卫生—肿瘤]