超声诊断触诊阴性BI-RADS 3类乳腺病变的恶性特征  

Research on malignant characteristics of non-palpable BI-RADS 3 breast lesions under ultrasound

作　　者：王喻 于乐漪 苑著[3] 史宪全[4] Wang Yu;Yu Leyi;Yuan Zhu;Shi Xianquan(Galactophore Ward,Beijing Hepingli Hospital,Beijing 100013,China;Department of Wound Repair Surgery,Beijing Haidian Hospital,Haidian Section of Peking University Third Hospital,Beijing 100080,China;Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]北京市和平里医院乳腺科,北京100013 [2]北京大学第三医院海淀院区北京市海淀医院创面外科,100080 [3]首都医科大学附属北京友谊医院普外分中心,北京100050 [4]首都医科大学附属北京友谊医院超声科,北京100050

出　　处：《中华健康管理学杂志》2023年第10期745-749,共5页Chinese Journal of Health Management

摘　　要：目的分析超声诊断触诊阴性乳腺影像报告和数据系统(BI-RADS)3类乳腺病变的恶性影像学特征。方法本研究为回顾性病例对照研究。选取2016年2月至2018年2月就诊于首都医科大学附属北京友谊医院的触诊阴性乳腺病变(NPBL)、乳腺超声检查结果BI-RADS 3类的乳腺病变,行超声引导下空芯针穿刺活检和病理检查患者161例。以临床病理结果为金标准分为良性组153例、恶性组8例,根据一般特征及超声报告特点回顾性分析相关危险因素。采用Fisher精确概率法进行单因素比较。将存在相关关系的变量纳入二元logistic回归分析,寻找恶性特征的独立危险因素;有统计学意义的因素绘制受试者工作特征(ROC)曲线以评估诊断效果;曲线下面积(AUC)分析临界值、灵敏度和特异度。结果年龄≥45岁(OR=35.036,P=0.012)、病变最大径在1~1.3 cm(OR=25.047,P=0.008)和纵横比为0.56~0.72(OR=19.860,P=0.013)可显著影响病变良恶性,是独立危险因素。构建ROC曲线评估诊断价值的AUC分别是0.732、0.724和0.751;灵敏度为87.5%、62.5%和75%;特异度为58.8%、82.4%和75.2%;阳性预测值为10.0%、15.6%和13.6%;阴性预测值为98.9%、97.7%和98.3%。结论NPBL BI-RADS 3类乳腺病变中,年龄≥45岁、超声提示1~1.3 cm的病变最大径、0.56~0.72纵横比的病变恶性危险性高。Objective To investigate the malignant imaging characteristics of non-palpable Breast Imaging-Reporting and Data System 3 breast lesions(NPBL BI-RADS 3 breast lesions)with ultrasound-guided core needle biopsy.Methods From February 2016 to February 2018,the ultrasound characteristics of 161 NPBL BI-RADS 3 breast lesions in Beijing Friendship Hospital,Capital Medical University were retrospectively collected with ultrasound-guided core needle biopsy and pathological examination.According to the pathological results,the patients were divided into two groups:benign group(153 cases)and malignant group(8 cases).Associated risk factors were analyzed retrospectively according to general characteristics and characteristics of the ultrasound report.The Fisher exact probability test was used for single-factor comparative analysis.Significant variables based on univariate analysis were included in multivariate regression analysis,and then logistic regression was used to search for clinical risk parameters and ultrasound malignant signs.The receiver operating characteristic(ROC)curve was plotted with statistically significant factors to evaluate the diagnostic efficacy.In combination with the area under the curve(AUC),the parameter integral critical value,sensitivity and specificity were analyzed.Results The age≥45 years(OR=35.036,P=0.012),the maximum lesion diameter of 1-1.3 cm(OR=25.047,P=0.008)and a aspect ratio of the lesion of 0.56-0.72(OR=19.860,P=0.013)could significantly affect the benign and malignant nature of the lesions,could be independent risk factors.The AUCs for constructing ROC curves to assess the diagnostic values of the above-mentioned indices were 0.732,0.724 and 0.751,respectively;the sensitivity was 87.5%,62.5%and 75%;the specificity was 58.8%,82.4%and 75.2%;the positive predictive values was 10.0%,15.6%and 13.6%;the negative predictive values was 98.9%,97.7%and 98.3%,respectively.Conclusion Of the NPBL BI-RADS 3 breast lesions,the malignant risk of lesions with an age≥45 years,maximum diameter of 1

关 键 词：超声检查 乳腺疾病 影像报告 数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]