女性X线乳腺密度的影响因素分析

The influencing factors of female's mammographic density

目的通过对乳腺X线片上乳腺密度及女性问卷调查的综合分析,探讨女性X线乳腺密度的影响因素,为乳腺癌的早期筛查及预防工作提供第一手临床资料。方法对随机抽取的1700例(其中门诊1020例,体检680例)女性进行乳腺X线摄影和问卷调查,按X线片上乳腺密度分型后纳入高、低密度组,探讨乳腺密度及其与年龄、体质量指数(BMI)、社会经济地位、生活方式和生殖生育情况的关系。结果单因素分析结果显示,乳腺密度的相关因素有年龄(P=0.000)、体质量指数(P=0.000)、初潮年龄(P=0.000)、产次(P=0.000)、流产次数(P=0.000)、婚姻状况(P=0.005)、心理素质(P=0.000)、饮酒情况(P=0.008)及是否发生过性关系(P=0.034)、生产(P=0.002)、绝经(P=0.000)、服用过避孕药(P=0.046)、职业(P=0.000)、文化程度(P=0.000)及性格特点(P=0.016)。多因素分析(logistic回归分析)结果显示,乳腺密度的相关因素有年龄(P=0..000)、体质量指数(P=0.000)、产次(P=0.073)、流产次数(P=0.000)、职业(P=0.042)、心理素质(P=0.013)、绝经情况(P=0.000)。结论年龄、体质量指数、初潮年龄、产次、流产次数、职业、婚姻状况、文化程度、心理素质、性格特点、饮酒习惯、性生活关系、生产、绝经、避孕药服用情况是乳腺密度的影响因素,对高密度人群诊断时应结合其他影像检查结果进行综合分析以提高乳腺癌的筛查,寻找可靠的量化评估乳腺密度的方法是未来研究的方向。

Objective To explore the relationship between mammographic density and SES,body mass index（BMI）,lifestyle and reproductive fertility situation through discussion and analysis of female＇s mammagraphy and questionnaire survey in order to provide first-hand clinical data for early breast cancer screening and prevention.Methods1700 mammary gland patients taken mammography and accepted the questionnaire survey.The patients were divided into high-density group and low-density group.The relationship between mammographic density and age,BMI,SES,lifestyle and reproductive fertility situation were analyzed.Results The univariate analysis showed that the related factors of mammographic density were age,BMI,age of menarche,parity,number of abortions,marital status,educational level,psychological quality and character,alcohol consumption,sexual relationship,production,menopause and contraceptives use.The unconditional logistic regression analysis showed that the significant risk factors were age,BMI,Parity,number of abortions,profession,anxiety and menopause.Conclusion Age,BMI,age of menarche,parity,number of abortions,occupation,marital status,educational level,psychological quality,character,alcohol consumption,sexual relationship,production,menopause and contraceptives were influencing factors of mammographic density.In clinical diagnosis of high-density population,results of other imaging of breast should be considered for comprehensive analysis.