乳腺钼靶片中簇状钙化对乳腺癌的诊断价值探讨

The Diagnostic Value of Clustered Calcification Found by Mammography in Breast Cancer

目的 探讨由乳腺钼靶片发现簇状钙化在乳腺疾病X线诊断中的意义 ,分析其对乳腺癌的诊断价值。方法 回顾性分析 5 8例乳腺X线钼靶片显示簇状钙化病例 ,全部经手术病理证实 ,其中乳腺恶性病变 3 8例 ,良性病变 2 0例。采用下列 5项指标分析上述 5 8例簇状钙化的特征并进行良恶性对照研究 :⑴每平方厘米钙化数目 (N/S) ;⑵病灶钙化总数 ;⑶钙化灶的大小形态 ;⑷钙化灶合并肿块存在 ;⑸钙化灶的分布与肿块的关系。结果 5 8例簇状钙化病例中N/S≥ 10个、钙化总数 >3 0个、各钙化灶大小形态不一致、钙化合并肿块、如合并肿块钙化灶分布于肿块内外这 5项观察指标的良恶性病例数分别为 6/3 0、2 /2 2、13 /3 7、10 /15、1/10 ;诊断恶性钙化的敏感度和特异度分别为 78 9%和 70 %、5 7 9%和 90 %、97 4%和 3 5 %、3 9 5 %和 5 0 %、67%和 90 %。结论 N/S≥ 10个、钙化总数 >3 0个及钙化灶合并肿块存在时肿块病灶内外均见钙化灶分布这三个特征对恶性钙化最具诊断价值 ,其次各钙化灶大小形态不一致 。

Objective To explore the diagnostic value of the clustered calcification found by mammography in the breast cancer. Methods Fifty-eight patients with clustered calcification found by mammography were analyzed retrospectively, including 38 cases with breast cancer and 20 cases with breast benign lesions,which were confirmed by pathology. The characteristics of the clustered calcification of benign and malignant breast lesions were compared. Results When the number of calcification per square centimeter (N/S)≥10 was taken as criteria of malignant calcification, there were 6 benign cases and 30 malignant cases, and the sensitivity and specificity for diagnosis of breast cancer was 78 9% and 70% respectively. When the total number of calcification>30 was taken as criteria, there were 2 benign cases and 22 malignant cases, the sensitivity and specificity for diagnosis of breast cancer was 57 9% and 90% respectively. When the shape and size of calcification was taken as criteria, there were 13 benign cases and 37 malignant cases, the sensitivity and specificity for diagnosis of breast cancer was 97 4% and 35% respectively. When both the calcification and breast mass were taken as criteria, there were 10 benign cases and 15 malignant cases, the sensitivity and specificity for diagnosis of breast cancer was 39 5% and 50% respectively. When the calcification distributed in and around the breast mass was taken as criteria, there were 1 benign case and 10 malignant cases, the sensitivity and specificity for diagnosis of breast cancer was 67% and 90% respectively. Conclusion N/S≥10, the total number of calcification>30 and calcification distribution were the most reliable signs for the diagnosis of breast cancer. The shape and size of calcification also were helpful to the differential diagnosis of benign and malignant breast lesions.