城市高危人群乳腺癌不同筛查方案诊断价值的应用评价

Evaluation on different methods in breast cancer screen among the population at high risk

目的:评价乳腺B超、乳腺X线及两者结合的方法在城市高危人群乳腺癌筛查中的诊断价值。方法:通过防癌风险评估问卷调查筛选出乳腺癌高风险人群,乳腺B超和X线检查进行乳腺癌筛查,利用ROC曲线分析法评价不同筛查方案的应用价值。结果:在3 275例高危人群中,共检出乳腺癌12例,检出率为366.41/10万。单独乳腺B超检查、单独乳腺X线检查、B超+X线、B超-X线筛查模式的灵敏度分别为53.85%、84.62%、92.31%和53.85%,ROC曲线下面积分别为0.802、0.959、0.964和0.805,Z检验结果显示B超+X线筛查模式具有较高的诊断能力(P<0.05)。结论:乳腺B超、乳腺X线均是乳腺癌筛查的有效方法,各有优缺点。两者综合可以相互弥补,提高早期乳腺癌的检出率。

Objective： To evaluate the value of breast ultrasound,mammography and the combination of the two methods for breast cancer screening among the high risk group. Methods： The breast cancer screening was performed in population at high risk who selected by cancer risk assessment questionnaire survey. The screening methods included breast ultrasound and mammography. The application values for different methods were evaluated by ROC curves.Results： There were 12 diagnosed cases among the 3 275 high risk women,the relevance ratio of breast cancer was366. 41 /100000. The sensitivity of breast ultrasound,mammography,comprehensive examination and the way of breast ultrasound→mammography was 53. 85%,84. 62%,92. 31% and 53. 85%. The area under the ROC curves of different methods was 0. 802,0. 959,0. 964 and 0. 805. After Z test,comprehensive examination was better than other methods（ P〈0. 05）. Conclusion： Both breast ultrasound and mammography are the effective methods in breast cancer screening,but each has its advantages and disadvantages,the combination of the two can make up for each other,improve the relevance ratio of early breast cancer.