超声检查征象logistics回归鉴别乳腺化生性癌和浸润性导管癌  

Logistic regression of ultrasound signs in differentiating female breast metaplastic carcinoma from invasive ductal car⁃cinoma

作　　者：符凤妹 方锋凯 符妹垂 FU Fengmei;FANG Fengkai;FU Meichui(Department of Ultrasonography,Hainan West Central Hospital,Danzhou 571799,China)

机构地区：[1]海南西部中心医院超声科,海南儋州571799

出　　处：《医学影像学杂志》2024年第5期82-86,共5页Journal of Medical Imaging

基　　金：海南省自然科学基金项目(编号:822RC855)。

摘　　要：目的 探讨乳腺病变超声检查征象在乳腺化生性癌和浸润性导管癌中的鉴别诊断价值。方法 选取在我院经手术病理证实的117例乳腺肿瘤患者的超声声像图,根据病理结果分为化生性癌组36例和浸润性导管癌组81例,就其超声检查征象进行单因素分析,将超声检查征象中有统计学意义的参数设为自变量进行Logistic回归分析。结果 单因素分析显示,超声检查肿瘤大小、回声类型、后方回声和生长方位在鉴别乳腺化生性癌和浸润性导管癌中差异均有统计学意义(P<0.05);多因素中肿瘤大小、回声类型、后方回声和生长方位是鉴别二者的独立影响因素,建立的回归方程为:Logistic (Y)=-2.209+1.335X1+2.186X2-1.149X3-1.734X4 (X1:肿瘤大小;X2:回声类型;X3:后方回声;X4:生长方位),ROC曲线下面积0.901,Logistic回归模型鉴别乳腺化生性癌和浸润性导管癌的灵敏度、特异度、准确率分别是61.1%、96.3%和87.2%。结论 多因素分析在鉴别乳腺化生性癌和浸润性导管癌中有较好的诊断效能,超声检查显示肿瘤大小、回声类型、后方回声和生长方位可作为综合判断二者的可靠指标。Objective To investigate the value of ultrasonographic features of breast lesions in the differential diagnosis of metaplastic carcinoma and invasive ductal carcinoma of the breast.Methods The ultrasound images of 117 patients with breast tumors confirmed by operation and pathology in Hainan West Central Hospital were analyzed retrospectively.According to the pathological results,the patients were divided into metaplastic carcinoma group(n=36)and invasive ductal carcinoma group(n=81).The ultrasound signs were analyzed by univariate analysis,and the statistically significant parameters of ultrasound signs were set as independent variables for Logistic regression analysis.Results Univariate analysis showed that there were sig⁃nificant differences in tumor size,echo type,posterior echo and growth orientation in the differential diagnosis of breast meta⁃plastic carcinoma and invasive ductal carcinoma(P<0.05).Tumor size,echo type,rear echo and growth orientation were inde⁃pendent factors to distinguish the two.The regression equation was Logistic(Y)=-2.209+1.335X1+2.186X2-1.149X3-1.734X4(X1:tumor size;X2:echo type;X3:rear echo).X4:orientation),the area under the ROC curve was 0.901.The sensitivity,specificity and accuracy of the model for distinguishing metaplastic breast cancer from invasive ductal carcinoma were 61.1%,96.3%and 87.2%,respectively.Conclusion Multivariate analysis is effective in the differential diagnosis of breast metaplas⁃tic carcinoma and invasive ductal carcinoma.Ultrasound can be used as a reliable index to comprehensively judge the size,echo type,posterior echo and orientation of breast metaplastic carcinoma and invasive ductal carcinoma.

关 键 词：乳腺癌 浸润性导管癌 乳腺化生性癌 超声检查 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]