乳腺浸润性导管癌患者的超声征象及漏诊的影响因素  

Ultrasound signs of breast infiltrating ductal carcinoma and the influencing factors of missed diagnosis

作　　者：夏小炎 陈思琪 郭莹 XIA Xiaoyan;CHEN Siqi;GUO Ying(Department of Ultrasound,Nanchang People’s Hospital,Nanchang 330000,Jiangxi,China)

机构地区：[1]南昌市人民医院超声科,江西南昌330000

出　　处：《癌症进展》2025年第6期728-730,734,共4页Oncology Progress

摘　　要：目的探讨乳腺浸润性导管癌(IDC)患者的超声征象及漏诊的影响因素。方法选取经手术病理检查确诊的60例IDC患者,全部患者均于术前行超声检查,根据超声检查结果与病理检查结果的一致性分为一致组(n=49)和非一致组(n=11)。比较两组患者的临床特征及超声征象,采用多因素Logistic回归模型分析乳腺IDC患者漏诊的影响因素。结果60例乳腺IDC患者中,经超声检查检出49例,检出率为81.67%。一致组中肿瘤直径≥2 cm、临床分期为Ⅲ期、有淋巴结转移的患者比例均高于非一致组,差异均有统计学意义(P﹤0.05)。一致组中形态规则、边界清楚的患者比例均低于非一致组,有微钙化、丰富血供、有可疑淋巴结的患者比例均高于非一致性组,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,无微钙化、无丰富血供的超声征象是乳腺IDC患者漏诊的独立危险因素(P﹤0.05)。结论乳腺IDC的超声征象缺乏恶性特征是导致患者漏诊的原因,尤其是在无微钙化、无丰富血供的情况下,应警惕漏诊的可能,对于有此类征象的患者应加强诊断和分析,以提高诊断准确率。Objective To explore the ultrasound signs of breast infiltrating ductal carcinoma(IDC)and the influencing factors of missed diagnosis.Method A total of 60 patients with IDC diagnosed by surgical and pathological examination were selected.All patients underwent ultrasound examination before surgery,and were divided into consistent group(n=49)and non-consistent group(n=11)according to the consistency of ultrasound examination results and pathological examination results.The clinical features and ultrasound signs of the two groups were compared,and the influencing factors for missed diagnosis of patients with breast IDC were analyzed by multivariate Logistic regression model.Result Among 60 patients with breast IDC,49 cases were detected by ultrasonography,the detection rate was 81.67%.The proportion of patients with tumor diameter≥2 cm,clinical stage III and lymph node metastasis in consistent group were higher than those in non-consistent group,the differences were statistically significant(P<0.05).The proportion of patients with regular shape and clear boundary in consistent group were lower than those in non-consistent group,and the proportion of patients with microcalcification,rich blood supply and suspicious lymph nodes were higher than those in non-consistent group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that ultrasound signs without microcalcification and rich blood supply were independent risk factors for missed diagnosis of patients with breast IDC(P<0.05).Conclusion The lack of malignant features of ultrasound signs in breast IDC patients is the cause of missed diagnosis,especially in the absence of microcalcification and rich blood supply,the possibility of missed diagnosis should be vigilant,and the diagnosis and analysis should be strengthened for patients with such signs to improve the diagnostic accuracy.

关 键 词：乳腺浸润性导管癌 超声 漏诊 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]