7204例女性乳腺BI-RADS分类与BMI、子宫状态的相关性

Study on BI-RADS CIassification of breast and BMI、uterine status factors among 7 204 women

目的:通过分析健康女性乳腺BI-RADS分类与其可能影响因素的关系,以更早期通过干预达到一级预防。方法:以我院近5年7 204例健康体检女性作为研究对象,分析其乳腺超声与年龄、BMI、甘油三酯、总胆固醇、高密度胆固醇(HDL-C)、葡萄糖、子宫状态的关联,乳腺报告采用美国放射学会乳腺影像学报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)判读结果,对各项数据进行卡方检验与Logistic多因素分析。结果:年龄、甘油三酯、总胆固醇、HDL-C、葡萄糖对乳腺BI-RADS分类没有影响(P>0.05);BMI(P=0.004)与子宫状态(P=0.000)是BI-RADS分类的独立影响因素;低体质(OR=0.696,95%CI=0.502~0.966)、超重(OR=0.217,95%CI=0.142~0.333)、肥胖(OR=0.123,95%CI=0.066~0.231)与BI-RADS分类呈负相关,子宫缺失(OR=19.189,95%CI=14.055~26.198)、子宫肌瘤(OR=4.384,95%CI=3.499~5.492)、绝经期子宫(OR=3.283,95%CI=2.374~4.541)是BI-RADS高分类的危险因素。结论:BMI与子宫状态是BI-RADS高分类的独立危险因素,这种关联不依赖于其他因素独立存在。子宫状态与乳腺BI-RADS关联,发现子宫缺失对乳腺BI-RADS分类极具影响。

Objective To achieve primary intervention from early on the analysis concerning correlations between BI-RADS classification and the factors that might influence it was conducted. Methods In this paper, the women involved in the 7 204 cases of physical examinations in our hospital （over the past 5 years） were chosen as the subjects investigated. The correlations between their breast ultrasounography results and the factors such as age, BMI, triglycerides, total cholesterol, glucose, and uterine status were analyzed. The breast report used the Breast imaging reporting and data system （also known as BI-RADS） of the American Society of Radiology to interpret the results. Chi-square test and logistic multivariate analysis of data were analyzed by SPSS 13 statistical soft- ware. Results The age, triglyceride, total cholesterol, HDL and glucose were not the factors influencing BI- RADS classification （P 〉 0.05 ） ; BMI （P = 0.004） and uterine status （P = 0.000） turned out to be the independent factors. Low body weight [ odds ratio （OR） = 0.696,95% Confidence interval （CI） = 0.502 - 0.966 ] , overweight （OR = 0.217,95%CI = 0.142 - 0.333）, and obese（OR = 0.123,95%CI = 0.066 ~ 0.231 ） were negatively correlated with it. Hysterectomy （OR = 19.189, 95%CI = 14.055 - 26.198）, （OR = 4.384, 95%CI = 3.499 - 5.492）, uterine fibroids, menopausal uterus were found to be the risk factors （OR = 3.283, 95%CI = 2.374 - 4.541）. Conclusion For the premenopausal women, being overweight or underweight can help reduce the risk of getting breast diseases. However, those suffering absence of uterus, or uterine fibroids, or in their menopausal period, are supposed to be among the high-risk group of breast cancer for regular screening.