超声BI-RADS分类在鉴别男性乳腺良恶性疾病中的诊断价值  

Clinical value of BI-RADS ultrasonography in the differential diagnosis of benign and malignant male breast diseases

作　　者：谭荣 唐奇 蒋雅玲 向宇琦 盘丽娟[4] TAN Rong;TANG Qi;JIANG Yalin;XIANG Yuqi;PAN Lijuan(Department of Ultrasonography,First Hospital of Changsha,Changsha 410005,China)

机构地区：[1]湖南长沙市第一医院超声科,410005 [2]湖南长沙市第一医院乳腺科,410005 [3]湖南长沙市第一医院病理科,410005 [4]中南大学湘雅医院产科超声

出　　处：《中国生育健康杂志》2023年第4期325-331,共7页Chinese Journal of Reproductive Health

基　　金：长沙市自然科学基金(kq2014005);湖南省自然科学基金青年项目(2020JJ5917)。

摘　　要：目的探讨超声BI-RADS分类在常见的男性乳腺发育与乳腺癌(MBC)中的鉴别诊断价值。方法回顾性分析2010年1月—2021年1月于本院乳腺外科因乳腺肿块就诊的男性患者,最终纳入研究91例,91例患者做了活检或手术切除病变,其中乳腺发育患者62例,年龄18~75岁;MBC 29例,年龄37~86岁。应用受试者工作特征(ROC)曲线计算超声BI-RADS鉴别29例MBC及62例男性乳腺发育的诊断效能。总结MBC超声声像图特点,比较MBC病理分级及亚型的特点。结果MBC发病年龄高于男性乳腺发育者,但是肿块直径小于后者。超声BI-RADS分类在区别两组疾病的敏感性、特异性分别为96.6%、95.2%。典型的MBC的超声特点是低回声(100%),平行生长(82.8%),不规则(81.5%)。病理类型主要为雌激素受体(ER),孕激素受体(PR)阳性的luminaA和luminaB型乳腺癌。结论超声BI-RADS 4类和5类对MBC有较高的诊断价值。由于MBC病理类型较少,其与女性非特殊类型浸润性乳腺癌声像图类似。Objective The aim of this study was to analyze the value of the Breast Imaging Reporting and Data System(BI-RADS)ultrasonography in the differential diagnosis of gynecomastia and male breast cancer(MBC).Methods The study was a retrospective analysis of male patients who visited breast surgery department of our hospital for breast lumps from January 2010 to January 2021.All of the 91 patients in the study underwent biopsy or surgical resection of lesions,including 62 patients(aged 18-75 years old)with gynecomastia and 29 patients(aged 37-86 years old)with MBC.The receiver operating characteristic(ROC)curve was used to calculate the diagnostic performance of BI-RADS categorization.We summarized the characteristics of MBC ultrasound images,and compared the characteristics of MBC pathological grades and subtypes.Results The onset age of patients with MBC was older than those with gynecomastia,however,the tumor diameter is smaller than that of the latter(P<0.05).The sensitivity and specificity of ultrasonic BI-RADS classification in the two groups were 96.6%and 95.2%,respectively.The typical ultrasound features of MBC in our research were hypoechoic(100%),parallel(82.8%)and irregular(81.8%)shape lesions.The pathological types were mainly lumina A and lumina B tumors with the positive expression rates of estrogen receptor(ER)and progesterone receptor(PR).Conclusion Ultrasound BI-RADS classification 4 and 5 had a high diagnostic value of differential male breast lesions.Due to the less pathological subtypes of MBC,it is similar to the sonographic image of non-special type invasive breast cancer among female population.

关 键 词：超声 BI-RADS 男性乳腺癌(MBC) 男性乳腺发育 

分 类 号：R71[医药卫生—妇产科学]