数字乳腺断层X射线成像联合血清CHAC1和RAI14在鉴别乳腺肿块良恶性中的价值分析  

Analysis for the value of digital mammography combined with serum CHAC1 and RAI14 in differentiating benign and malignant breast masses

作　　者：姚利敏 黄建霞 范红蕊 董静娟[1] 杜文政 廉晓晓 Yao Limin;Huang Jianxia;Fan Hongrui;Dong Jingjuan;Du Wenzheng;Lian Xiaoxiao(The Second Department of Imaging,Handan Maternal and Child Health Care Hospital,Handan 056001,China;Department of Imaging,Handan Infectious Disease Hospital,Handan 056008,China;Department of Traditional Chinese Medicine,Handan Central Hospital,Handan 057150,China)

机构地区：[1]邯郸市妇幼保健院影像二科,邯郸056001 [2]邯郸市传染病医院影像科,邯郸056008 [3]邯郸市中心医院中医科,邯郸057150

出　　处：《中国医学装备》2025年第3期43-47,共5页China Medical Equipment

摘　　要：目的:探讨数字乳腺断层X射线成像联合血清谷胱甘肽特异性γ-谷氨酰环转移酶1(CHAC1)和维甲酸诱导蛋白14(RAI14)在鉴别乳腺肿块良恶性的诊断价值。方法:前瞻性选取2019年6月至2024年6月在邯郸市妇幼保健院就诊治疗的189例女性乳腺肿块患者,根据病理活检结果将其分为良性肿块组(128例)和恶性肿块组(61例)。所有患者均行数字乳腺断层X射线成像检测,采用酶联免疫吸附法(ELISA)检测血清CHAC1和RAI14水平。分析患者一般临床资料,采用多因素logistic回归分析乳腺肿块良恶性影响因素,绘制受试者工作特征(ROC)曲线,分析CHAC1和RAI14对乳腺肿块良恶性的诊断价值,采用Kappa检验评估各诊断方法与病理结果的一致性。结果:189例乳腺肿块患者经数字乳腺断层X射线成像检测检出恶性肿块56例,良性133例,误诊13例,漏诊18例,与病理检测结果中度一致(Kappa=0.617,P<0.05)。与良性肿块组比较,恶性肿块组的血清CHAC1、RAI14水平均显著升高,两组比较差异有统计学意义(t=12.249、12.512,P<0.05)。患者年龄、绝经时间、CHAC1及RAI14均为影响乳腺肿块良恶性的危险因素(OR=1.368、1.305、1.897、1.995,P<0.05)。CHAC1诊断乳腺肿块良恶性的ROC曲线下面积(AUC)为0.816(95%CI:0.753~0.868),灵敏度为70.49%,特异度为89.06%;RAI14诊断乳腺肿块良恶性的AUC为0.838(95%CI:0.778~0.888),灵敏度为68.85%,特异度为89.84%。数字乳腺断层X射线成像、血清CHAC1和RAI14三者联合检出恶性肿块74例,良性肿块115例,误诊15例,漏诊2例,与病理检测结果一致性极高(Kappa=0.805,P<0.001)。数字乳腺断层X射线成像联合血清CHAC1、RAI14三者联合的灵敏度(96.72%)、阴性预测值(98.26%)以及准确率(91.01%)显著高于数字乳腺断层X射线成像,血清CHAC1和RAI14各单独预测,差异均有统计学意义(x^(2)=15.310、16.623、15.310、11.690、12.402、11.572、5.276、5.276、4.677,P<0.05)。结论:血清CHAC1和RAI14在乳Objective:To explore the diagnostic value of digital mammography combined with serum glutathione specific gamma-glutamyl transpeptidase 1(CHAC1)and retinoic acid-induced protein 14(RAI14)in identifying benign and malignant breast masses.Methods:A total of 189 patients with breast masses who were treated at Handan Maternal and Child Health Care Hospital from June 2019 to June 2024 were prospectively selected as the research subjects.According to the results of pathological biopsy,they were divided into benign mass group(128 cases)and malignant mass group(61 cases).All patients underwent digital mammography detection.The levels of serum CHAC1 and RAI14 were detected by enzyme-linked immunosorbent assay(ELISA).The general clinical data of the patients were collected and analyzed.Multivariate logistic regression analysis was used to analyze the factors of influencing benign and malignant nature of breast masses.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of CHAC1 and RAI14 for the benign and malignant nature of breast masses.The Kappa test was used to assess the consistency of results between each diagnostic method and the pathological detection.Results:For 189 patients with breast masses,digital mammography identified 56 cases of malignant masses and 133 cases of benign masses,and 13 cases of them were misdiagnosis and 18 cases of them were missed diagnosis.It showed a moderate consistency with the results of pathological detection(Kappa=0.617,P<0.05).Compared with the benign mass group,the levels of serum CHAC1 and RAI14 in the malignant mass group were significantly higher,and the differences of them between the two groups were statistically significant(t=12.249,12.512,P<0.05).The age,menopausal time,CHAC1 and RAI14 of the patients were all risk factors that can affect the benign and malignant nature of breast masses(OR=1.368,1.305,1.897,1.995,P<0.05).The area under curve(AUC),sensitivity and specificity of CHAC1 were respectively 0.816(95%CI:0.753~0.868),70.49%and 89.

关 键 词：数字乳腺断层X射线成像 谷胱甘肽特异性γ-谷氨酰环转移酶1(CHAC1) 维甲酸诱导蛋白14(RAI14) 乳腺肿块鉴别 

分 类 号：R814[医药卫生—影像医学与核医学]