数字乳腺X线检查对乳腺可疑钙化灶的诊断:基于188例患者分析  

Diagnosis of Suspected Breast Calcification by Digital Mammography:Based on 188 Patients Analysis

作　　者：高者 范文文 胡龙宾 欧阳汉 GAO Zhe;FAN Wen-wen;HU Long-bin;OUYANG Han(National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《肿瘤学杂志》2022年第9期741-746,共6页Journal of Chinese Oncology

摘　　要：[目的]分析数字乳腺X线检查对乳腺可疑钙化灶的诊断价值。[方法]收集2017年9月至2022年3月共755例临床触诊阴性、数字乳腺X线检查结果分级为Ⅳ级以上的乳腺可疑钙化灶患者,术前一周内均行超声检查,超声阴性的可疑钙化灶手术当日行数字乳腺X线金属丝定位,以病理结果为金标准,对可疑钙化灶的病理结果及影像学征象进行统计学分析。[结果]病理结果显示,755例患者中,恶性病变295例,良性病变460例。针对数字乳腺X线检查中发现的可疑钙化灶,超声检出率为75.10%(567/755)。数字乳腺X线检查钙化灶的灵敏度(91.18%)和准确率(85.56%)均高于超声的80.34%和79.73%,漏诊率(3.44%)和误诊率(10.99%)均低于超声的7.68%和12.58%,差异有统计学意义(P<0.05)。其中超声阴性,数字乳腺X线检查发现可疑钙化灶患者188例,术后病理结果为乳腺恶性病变79例,良性病变109例,恶性病变检出率42.02%;188例可疑钙化灶良恶性组间钙化灶的形态和分布、密度、数目差异均有统计学意义(P均<0.05)。[结论]数字乳腺X线检查在临床触诊阴性、超声阴性的可疑钙化灶诊断中有一定价值,适用于临床早期乳腺癌的诊断。[Objective]To analyze the diagnostic value of digital mammography for suspected breast calcification.[Methods]From September 2017 to March 2022,a total of 755 patients who were suspected breast calcification with negative clinical palpation and BI-RADS grading above gradeⅣconfirmed by digital mammography were collected.All patients underwent ultrasound examination within one week before operation.Suspicious calcifications with negative ultrasonography were located by digital mammography on the day of surgery.With pathological results as the gold standard,the pathological findings and imaging signs of suspected calcification foci were statistically analyzed.[Results]Pathological results showed that among the 755 patients,295were malignant lesions and 460 were benign lesions.The ultrasonic detection rate of suspected calcification on digital mammography was 75.10%(567/755).The sensitivity(91.18%)and accuracy(85.56%)of digital mammography to examine calcification were higher than those of ultrasound(80.34%and 79.73%).The rate of missing diagnosis(3.44%)and misdiagnosis(10.99%)were lower than those of ultrasound(7.68%and 12.58%),and the difference was statistically significant(P<0.05).188 patients were found negative by ultrasound and suspected calcification foci by digital mammography.The postoperative pathological results were malignant lesions in 79 cases and benign lesions in 109 cases,with a detection rate of 42.02%.There were significant differences in the morphology,distribution,density and number of calcified foci between benign and malignant groups(P<0.05).[Conclusion]Digital mammography has certain value in the diagnosis of suspected calcification foci with negative clinical palpation and negative ultrasound,which is suitable for the diagnosis of early breast cancer.

关 键 词：乳腺癌 钙化灶 数字乳腺X射线检查 超声 

分 类 号：R737.9[医药卫生—肿瘤]