超声BI-RADS分类联合血清TFF1、GDF3对乳腺肿块良恶性的鉴别诊断价值  

Value of ultrasound BI-RADS classification combined with serum trefoil factor 1 and growth differentiation factor 3 in differential diagnosis of benign and malignant breast masses

作　　者：高秋燕[1] 李涛 韩素桂[2] GAO Qiuyan;LI Tao;HAN Sugui(Physical Examination Center Ultrasonography Room,Tangshan People’s Hospital,Tangshan,Hebei 063001,P.R.China;Nuclear Medicine Laboratory,Tangshan People’s Hospital,Tangshan,Hebei 063001,P.R.China)

机构地区：[1]唐山市人民医院体检中心超声室,河北唐山063001 [2]唐山市人民医院核医学检验科,河北唐山063001

出　　处：《中国普外基础与临床杂志》2025年第1期88-92,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：河北省医学科学研究课题计划项目(项目编号:20241561)。

摘　　要：目的探究超声乳腺成像报告和数据系统(breast imaging reporting and data system,BI-RADS)分类联合血清三叶因子1(trefoil factor 1,TFF1)、人生长分化因子3(growth differentiation factor 3,GDF3)水平对乳腺肿块良恶性的鉴别诊断价值。方法前瞻性收集2020年9月至2023年9月期间唐山市人民医院诊治的113例女性乳腺肿块患者为研究对象。使用超声诊断仪进行超声BI-RADS分类,采用ELISA法检测血清TFF1、GDF3水平,采用一致性Kappa检验比较超声BI-RADS分类、血清TFF1水平、GDF3水平单独及联合诊断与病理结果的一致性,并采用受试者工作特征(receiver operating characteristic,ROC)曲线分析上述指标单独及联合应用对乳腺肿块良恶性的诊断价值。结果113例乳腺肿块患者中,病理诊断结果显示良性肿块48例,恶性肿块65例。恶性患者的血清TFF1[(1.62±0.25)μg/L比(1.24±0.27)μg/L]、GDF3[(118.62±21.73)ng/L比(96.47±16.05)ng/L]水平高于良性患者(P<0.001)。超声BI-RADS分类、血清TFF1水平、血清GDF3水平联合诊断乳腺肿块恶性70例,良性43例,与病理结果的一致性极高,Kappa值为0.835(P<0.001);三者联合诊断乳腺肿块良恶性的灵敏度为96.92%(63/65),特异度为85.42%(41/48),阴性预测值为95.35%(41/43),阳性预测值为90.00%(63/70),其灵敏度、阴性预测值、准确率高于超声BI-RADS分类及血清GDF3水平单独诊断(P<0.05),漏诊率低于超声BI-RADS分类及血清GDF3水平单独诊断(P<0.05)。结论乳腺肿块恶性患者的血清TFF1、GDF3水平升高,超声BI-RADS分类联合血清TFF1、血清GDF3水平可提高对乳腺肿块良恶性诊断的灵敏度与准确率,降低漏诊率。Objective To explore the classification of ultrasound breast imaging reporting and data system(BIRADS)classification combined with serum trefoil factor 1(TFF1)and human growth differentiation factor 3(GDF3)in the differential diagnosis of benign and malignant breast masses.Methods The prospective study collected 113 female patients with breast masses who got treatment in Tangshan People’s Hospital from September 2020 to September 2023.Ultrasound diagnostic equipment was applied for ultrasound BI-RADS classification,ELISA method was applied to detect serum TFF1 and GDF3 levels,Consistency Kappa test was used to compare the consistency of ultrasound BI-RADS classification,serum TFF1 and GDF3 alone and combined in the diagnosis of benign and malignant breast masses and pathological results,In addition,receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of the above indicators in the diagnosis of benign and malignant breast masses.Results Among the 113 patients with breast mass,the pathological diagnosis showed benign mass in 48 cases and malignant mass in 65 cases.The serum levels of TFF1[(1.62±0.25)μg/L vs(1.24±0.27)μg/L]and GDF3[(118.62±21.73)ng/L vs(96.47±16.05)ng/L]in malignant patients were obviously higher than those in benign patients(P<0.001).There were 70 cases of malignant breast masses and 43 cases of benign breast masses according ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3.The diagnosis consistency with pathological results was very high and Kappa value was 0.835(P<0.001).The sensitivity and specificity of ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3 in differential diagnosis of benign and malignant breast masses were 96.92%(63/65),85.42%(41/48),respectively,the negative predictive value was 95.35%(41/43),and positive predictive value was 90.00%(63/70).The sensitivity,negative predictive value and accuracy were higher than those of ultrasonic BI-RADS classification and serum GDF3 alone(P<0.05),and the mis

关 键 词：乳腺肿块 乳腺成像报告和数据系统 三叶因子1 人生长分化因子3 诊断 

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]