加速时间指数鉴别良、恶性乳腺肿物的临床研究

The clinical values of acceleration time index for the differentiation between benign and malignant breast tumors

目的利用加速时间指数(acceleration time index,ATI)鉴别乳腺癌及乳腺良性肿物,并通过受试者工作特征(receiver operating characteristic,ROC)曲线评价其可靠性。方法 ATI=加速时间/心动周期。所检测血流样本均来自肿物内部,不包括周边的血流信号。以病理结果为标准。利用ROC曲线评估ATI的诊断价值。结果 106个病变中,良性67个(纤维腺瘤34个,乳腺增生26个,乳腺腺病7个),恶性39个(非浸润性癌24个,浸润性癌15个)。良性肿物的ATI值(0.064～0.159,平均0.105)低于恶性肿物(0.084～0.250,平均0.176)。对于乳腺良、恶性肿物,ATI差异有统计学意义(P<0.01)。ROC曲线下面积为0.956,诊断价值高。以ATI=0.155作为最佳临界值具有较高的灵敏度(90%)和特异度(99%)。结论 ATI在鉴别乳腺良、恶性肿物方面具有极大优势。

Objective To determine whether the acceleration time index could reliably differentiate breast tumors with receiver operating characteristic（ROC） curve.Methods ATI（acceleration time/cardiac cycle time） was calculated from intratumoral flow,excluding peripheral blood flow signal.All the lesions were based on the results of histopathological or histological analyses.ATI was evaluated and compared between the benign and malignant groups.The diagnostic value of ATI was evaluated by using ROC curve.Results Among 67 breast benign tumors,there were 34 fibroadenoma,26 hyperplasia of mammary glands,7 sclerosing adenosis.In 39 malignant lesions,there were 24 non-invasive carcinoma,15 invasive carcinoma.The diagnostic values of ATI were lower in benign tumors（ATI,mean,0.105;range,0.064 ～ 0.159） than in malignant tumors（ATI,mean,0.176;range,0.084 ～ 0.250）.However,there were significant differences in the ATI values between benign and malignant groups（P〈 0.01）.The area under ROC curve was 0.956 and diagnostic value was better.An ATI value of 0.155 seemed to be the optimum threshold for the differentiation of benign and malignant lesions（90% sensitivity,99% specificity respectively）.Conclusion ATI is the most useful parameter for differentiating benign breast tumors from malignant breast tumors.