常规超声结合弹性成像对三阴性乳腺癌的诊断价值

Diagnostic value of conventional ultrasound combined with elasticity imaging in the diagnosis of three negative breast cancer

目的探讨常规超声结合弹性成像对三阴性乳腺癌的诊断价值。方法选取2010年12月至2012年10月间于我院诊治的149例乳腺癌患者,均行超声结合弹性成像检查后,行雌激素受体、人表皮生长因子受体2和孕激素受体检测。其中三阴乳腺癌(35例)为观察组,非三阴性乳腺癌(114例)为对照组,分析两组患者常规超声结合弹性成像的图像特征及常规超声结合弹性成像对三阴性乳腺癌诊断的准确性。结果观察组图像示边缘有毛刺征占28.6%、后方回声衰减占25.7%、微钙化占48.6%和内部血流低级别占22.9%,均明显低于对照组(分别为54.4%、46.5%、77.2%和41.2%),差异均有统计学意义(均P<0.05)。观察组低血流阻力指数占37.1%、低弹性评分占14.3%均高于对照组(分别为34.2%和9.6%),差异均无统计学意义(均P>0.05)。常规超声结合弹性成像对三阴性乳腺癌诊断的敏感度为94.3%,特异度为95.6%和准确度为95.3%。结论常规超声结合弹性成像在三阴性乳腺癌的诊断中具有重要的临床价值,综合分析患者病灶的形态,可显著提高疾病诊断的准确性,值得临床推广使用。

Objective To explore diagnostic value of conventional ultrasound combined with elasticity imaging in three negative breast cancer. Methods 149 patients with breast cancer were selected from December 2010 to October 2012 in Guang＇an People＇s Hospital. Ultrasonic elastography and conventional ultrasonography used firstly and then detected estrogen receptor（ ER）,human epidermal growth factor receptor-2（ HER2）,progesterone receptor（ PR）. Patients were divided into observation group（ 35 three negative breast cancer patients） and control group（ 114 no-three negative breast cancer patients） after qualitative diagnosis. Image feature and diagnosis accuracy of ultrasonic elastography and conventional ultrasonography was analyzed in two groups. Results Percentage of spiculation sign on edge 28. 6%,posterior echo attenuation 25. 7%,microcalcification 48. 6% internal low blood flow 22. 9% in observation group were significantly lower than control group 54. 4%,46. 5%,77. 2%,41. 2%. Difference was statistically significant（ P〈 0. 05）. Percentage of low blood resistance index 37. 1%,low elastic score 41. 2% in observation group were higher than control group 34. 2%,9. 6%. Difference was not statistically significant（ P〉 0. 05）. Sensitivity,specificity,accuracy of diagnosis by ultrasonic elastography and conventional ultrasonography were 94. 3%,95. 6%,95. 3%. Conclusions Conventional ultrasound combined with elasticity imaging has significant clinical value in diagnosis of three negative breast cancer. Though comprehensive analysis of lesion morphology,which can increase accuracy. That is worthy of clinical use.