微钙化超声显示在乳腺癌诊断中的价值及与预后的关系  

Diagnostic value of ultrasound in microcalcification in breast cancer and its relationship with prognosis

作　　者：陈潇 叶大才 李媚 关海天 龙金霞 CHEN Xiao;YE Dacai;LI Mei;GUAN Haitian;LONG Jinxia(Department of Ultrasound Medicine,Wuzhou Workers'Hospital,Wuzhou 543000,Guangxi,China;Department of General Surgery,Wuzhou Workers'Hospital,Wuzhou 543000,Guangxi,China)

机构地区：[1]梧州市工人医院超声医学科,广西梧州543000 [2]梧州市工人医院普外科,广西梧州543000

出　　处：《贵州医科大学学报》2023年第5期568-573,共6页Journal of Guizhou Medical University

基　　金：梧州市科学研究与技术开发计划项目(201502106)。

摘　　要：目的探讨微钙化超声显示在乳腺癌诊断价值及与预后关系分析。方法选取91例乳腺癌患者作为研究对象,以病理结果为金标准,经金标准检出微钙化共46例,并在术前给予超声检查,四格表法计算微钙化与无钙化预测值;采用受试者工作(ROC)曲线模型分析超声诊断乳腺癌微钙化的曲线下面积(AUC)、敏感度、特异度;并根据患者随访期间是否出现肿瘤复发、转移或死亡情况,将91例乳腺癌患者分为预后不良组(n=38)与预后良好组(n=53),采用二元logistic回归分析影响乳腺癌预后的危险因素。结果91例乳腺癌患者经超声检查后,微钙化预测值为86.67%,无钙化预测值为84.78%,与金标准相比,一致性较好(Kappa=0.714,P<0.001);经超声检出的39例微钙化乳腺癌患者中,肿块伴微钙化共29例、片状低回声伴微钙化2例、导管扩张伴微钙化4例、单纯微钙化共4例;ROC曲线分析显示,超声诊断乳腺癌微钙化的AUC为0.857(P<0.05)、敏感度为0.848、特异度为0.867;预后不良组与预后良好组在肿瘤直径、淋巴结转移、TNM分期、微钙化资料比较,差异有统计学意义(P<0.05);二元logistic回归分析显示,肿瘤直径≥2 cm、淋巴结转移、TNMⅢ~Ⅳ期、微钙化为影响乳腺癌患者预后的独立危险因素(P<0.05)。结论超声在乳腺癌中具有较为理想诊断效果,能通过检出微钙化灶为临床诊治提供指导意见,且微钙化灶是影响乳腺癌患者预后的危险因素之一。Objective To explore the diagnostic value of ultrasound in microcalcification in breast cancer and its relationship with prognosis.Methods A total of 91 patients with breast cancer were selected as research subject.Pathological examination was used as gold standard.There were 46 patients who had microcalcification diagnosed by their pathological results.Ultrasound examination was performed before surgery.The predicted values of microcalcification and non-calcification were calculated using the four-fold table method.The predictive effect of ultrasound in diagnosing microcalcification was analyzed using the area under receiver operating characteristic(ROC)curve(AUC),sensitivity and specificity of ROC curve.According to whether tumor relapse,metastasis or death occurred during the follow-up,91 patients with breast cancer were divided into poor prognosis group(n=38)and good prognosis group(n=53).Binary logistic regression was used to analyze the risk factors affecting the prognosis of breast cancer.Results After ultrasound examination for 91 patients with breast cancer,the predictive value of microcalcification was 86.67%,and the predictive value of non-calcification was 84.78%.When compared with the gold standard,the consistency was good(Kappa=0.714,P<0.001).Among 39 patients with microcalcification in breast cancer detected by ultrasonography,29 patients had mass with microcalcification,2 patinets with sheet hypoechoic with microcalcification,4 patients with duct dilatation with microcalcification and 4 patients with microcalcification alone.ROC curve analysis showed that AUC of ultrasound diagnosis of microcalcification in breast cancer was 0.857(P<0.05),and the sensitivity and the specificity were 0.848 and 0.867,respectively.There were significant differences in tumor diameter,lymph node metastasis,TNM staging and microcalcification between poor prognosis and good prognosis groups(P<0.05).Binary logistic regression analysis revealed that tumor diameter≥2 cm,lymph node metastasis,TNMⅢ-Ⅳstage,and microcalci

关 键 词：超声 微钙化灶 乳腺癌 预后 危险因素 淋巴结转移 肿瘤直径 

分 类 号：R737.9[医药卫生—肿瘤]