北京市适龄妇女免费乳腺癌筛查确诊病例回顾性分析  

Retrospective analysis of confirmed cases in free breast cancer screening for women of childbearing age in Beijing

作　　者：张妍[1] 沈洁[1] 张月[1] 高丽丽[1] 韩历丽[2] ZHANG Yan;SHEN Jie;ZHANG Yue;GAO Li-li;HAN Li-li(Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Beijing Maternal and Child Health Care Hospital,Beijing100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院妇女保健科,北京100026 [2]首都医科大学附属北京妇产医院/北京妇幼保健院保健部,北京100026

出　　处：《中华肿瘤防治杂志》2022年第19期1373-1377,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：北京市科学技术委员会AI+健康协同创新培育项目(Z201100005620011);首都医科大学附属北京妇产医院北京妇幼保健院管理专项课题(FCYYGL201901)。

摘　　要：目的通过分析北京市适龄妇女免费乳腺癌筛查中确诊为乳腺原位癌和浸润癌妇女的筛查情况,评价乳腺超声和乳腺X射线摄影检查在乳腺癌筛查中的应用效果,为提高乳腺癌筛查工作质量提供参考依据。方法采用2011-01-01-2018-12-31北京市乳腺癌筛查的数据,选择病理确诊为乳腺原位癌和浸润癌的1339名妇女作为研究对象,回顾性分析确诊妇女乳腺超声检查和X射线摄影检查的乳腺影像报告和数据系统(BI-RADS)分类结果与病理确诊结果的符合情况。结果病理确诊为乳腺原位癌和浸润癌的妇女中,共有1264名妇女在指定筛查和转诊机构接受了全部检查,其中1209名妇女检出原位癌或浸润癌,漏诊率为4.35%。2017-2018年,漏诊率下降到2.79%。接受超声检查的1337名妇女中,697人检查结果为BI-RADS分类≥4类,符合率为52.13%,159人超声筛查结果为1或2类,超声漏诊率为11.89%。接受乳腺X射线摄影检查的1166名妇女中,909人检查结果为≥4类,符合率为77.96%,257人检查结果为1或2类,乳腺X射线摄影检查漏诊率为7.20%。乳腺癌筛查工作开展以来,乳腺超声检查和乳腺X射线摄影检查的漏诊率均呈下降趋势。2017-2018年,乳腺超声漏诊率为8.33%,乳腺X射线摄影检查漏诊率为4.81%。结论乳腺超声及X射线摄影检查作为中国女性乳腺癌筛查常规的影像学检查方式具有诊断符合率稳定、漏诊率低的优点,应进一步加强对筛查人员的技术培训,规范检查技术,加强质量控制,重点提高对于乳腺恶性病变的识别能力。Objective To retrospectively analyze the screening results of confirmed carcinoma in situ and invasive carcinoma cases in free breast cancer screening program for women of childbearing age in Beijing,evaluate the application of ultrasonography and mammography,and provide material support to improve the quality of breast cancer screening program.Methods Data of 1339malignant cases confirmed by histopathology was collected from breast cancer screening program in Beijing from January 1,2011to December 31,2018.A retrospective analysis was conducted to evaluate the coincidence rate among histopathology results and breast imaging reporting and data system(BI-RADS)results of ultrasonography and mammography.Results A total of 1264cases accomplished the whole breast cancer screening progress and 1209cases were detected as carcinoma in situ and invasive carcinoma,the missing detection rate was 4.35%.From 2017to 2018,the missing detection rate dropped to 2.79%.Among 1337women received ultrasonography examination,697cases had BIRADS categories 4and above,and the coincidence rate was 52.13%.Totally 159cases had BI-RADS categories 1or 2,and the missing detection rate of ultrasonography was 11.89%.Among 1166women who received mammography examination,909cases had BI-RADS categories 4and above,the coincidence rate was 77.96%.Totally 257cases had BI-RADS categories 1or 2,and the missing detection rate of mammography was 7.20%.Since the development of breast cancer screening,the missing detection rates of ultrasonography and mammography showed a downward trend.From 2017to2018,the missing detection rate of ultrasonography was 8.33%,and the missing detection rate of mammography was 4.81%.Conclusions As the regular breast cancer screening methods among Chinese women,ultrasonography and mammography show the advantages of stable coincidence rates and low missing detection rates.We should strengthen the technical training for practitioners and the quality control,and improve the ability of detecting malignant lesions.

关 键 词：乳腺癌 筛查 乳腺超声 乳腺X射线摄影 

分 类 号：R737.9[医药卫生—肿瘤]