上海社区乳腺癌筛查初步小结:超声及乳腺X线的漏诊、误诊病例分析

The first stage conclusion of breast cancer screening in Shanghai community:missed and misdiagnostic cases analysis of mammography and ultrasonography

目的通过分析超声和钼靶在大规模体检中的漏诊、误诊病例,探讨超声和钼靶的应用价值。方法 7 025名正常女性接受超声和钼靶联合筛查,可疑病例通过手术获取病理结果,并与诊断结果对比。结果超声漏诊8例肿瘤患者,误诊为恶性病变72例;钼靶漏诊4例肿瘤患者,误诊为恶性病变220例;超声和钼靶同时漏诊2例肿瘤患者。结论超声和钼靶的误诊、漏诊受物理原理所限制,超声还受操作者经验的影响,两者联合可降低不利因素,提高恶性肿瘤的筛查率。

Objective To discuss the application values of both ultrasonography and mammography by analyzing missed and misdiagnostic cases in breast cancer screening including a large sample of community women.Methods A total of 7 025 women were examined by both ultrasonography and mammography.Those suspected cases were confirmed by surgical pathology.The results were compared with imaging diagnosis.Results Eight malignant cases were missed and 72 cases were misdiagnosed as malignant cases on ultrasonography.Four malignant cases were missed and 220 cases were misdiagnosed as malignant cases on mammography.Two malignant cases were missed by ultrasonography and mammography both.Conclusion Both ultrasonography and mammography are limited due to their physical principles.Ultrasound diagnosis is highly operater-dependent.The combination of them can reduce the defects and improve sensitivity in diagnosis of malignant tumors.