乳腺旺炽性腺病与浸润性导管癌的超声鉴别诊断研究  

Ultrasonic differential diagnosis between florid adenosis of breast and invasive ductal carcinoma

作　　者：廖春圆 杨洁[2] 黄金长[3] 陈小英 曾太阳 郭春娇 LIAO Chun-yuan;YANG Jie;HUANG Jin-chang;CHEN Xiao-ying;ZENG Tai-yang;GUO Chun-jiao(Ultrasound department of An yuan county women and children's hospital;Ultrasound department of Ganzhou People's hospital,Ganzhou,Jiangxi 341000;Pathology department of Ganzhou People's Hospital,Ganzhou,Jiangxi 341000)

机构地区：[1]安远县妇女儿童医院超声科 [2]赣州市人民医院超声科,江西赣州341000 [3]赣州市人民医院病理科,江西赣州341000

出　　处：《赣南医学院学报》2020年第11期1136-1139,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市科技局科技计划课题(GZ2018ZSF565)。

摘　　要：目的:探讨超声鉴别乳腺旺炽性腺病与浸润性导管癌的应用价值。方法:收集2015年1月—2019年3月具有完整病例的乳腺旺炽性腺病30例,浸润性导管癌30例。分析乳腺肿块BI-RADS分类,并与病理结果进行对照分析。结果:旺炽性腺病在大小(P=0.004)、形态(P=0.000)、边缘(P=0.033)、内部回声(P=0.000)、后方回声(P=0.000)、钙化(P=0.000)、血流信号(P=0.000)、BI-RADS分类方面(P=0.000)与浸润性导管癌比较差异有统计学意义(P<0.05)。BI-RADS-US构建的ROC曲线下面积AUC(0.800±0.060)(95%CI可信区间:0.682~0.917)(P=0.000),其敏感度87%,特异性73%,阳性预测值86.7%,阴性预测值72.9%,一致性检验kappa=0.567。结论:超声从肿块的大小、形态、边缘、内部回声、后方回声、钙化、血流信号、BI-RADS分类,尤其是毛刺周边回声、走形,肿块内部回声与周边正常腺叶回声的差异等方面,可对乳腺旺炽性腺病与浸润性导管癌进行鉴别。Objective:To explore the ultrasound's application value in the terms of differential diagnosis between florid adenosis and invasive ductal carcinoma.Methods:From January 2015 to March 2019,30 cases of florid breast adenosis and 30 cases of invasive ductal carcinoma which had complete data were collected,then BI-RADS-US and pathological results were analyzed with each other.Results:There were statistically significant differences in the terms of mass size(P=0.000),shape(P=0.000),internal echo(P=0.000),margin(P=0.023),posterior echo(P=0.000),calcification(P=0.000)and blood flow signal(P=0.000),classification of BI-RADS-US(P=0.000)between florid adenosis and invasive ductal carcinoma.The construction of the ROC curves for BI-RADS-US to distinguishing the diagnostic between invasive ductal and florid adenosis,the areas under ROC curve were(0.800±0.060)(95%CI:0.682-0.917)(P=0.000),The sensitivity,specificity,positive predictive value and negative predictive value were 86%,73%,86.7%and 72.9%,kappa consistency test equal to 0.567.Conclusion:Ultrasound can be applied to distinguish between breast florid adenosis and invasive ductal carcinoma from the aspects of mass size,margin,internal echo,posterior echo and blood flow signal and classification of BI-RADS-US,especially,the rim echo and the extend way of the spiculated margin,the difference between mass initernal echo and breast lobules.

关 键 词：乳腺旺炽性腺病 浸润性导管癌 超声检查术 多普勒 彩色 

分 类 号：R445.1[医药卫生—影像医学与核医学]