乳腺癌患者活检术后残瘤灶的超声与钼靶X线成像对比研究

Comparison of Ultrasound and Mammography in Detecting Residual Disease Following Bioptic Lumpectomy in Breast Cancer Patients

目的比较钼靶X线成像（MMG）与超声（US）对乳腺癌活检术后残瘤灶诊断的准确性。方法搜集2013年8月至2016年10月本院均经手术活检证实为原发性乳腺癌患者215例,所有患者首次手术切除活检诊断后均再次行保乳切除术或全乳切除术,并以手术病理结果为对照;比较分析US和MMG方法的准确性和灵敏度。结果 138例（64.19%）乳腺癌患者二次手术后病理证实存在残瘤灶,其中导管原位癌（DCIS）63例（45.65%）。MMG发现残瘤灶的敏感度、准确度分别为65.94%和72.56%,高于US的32.61%和53.95%,两者之间具有显著统计学差异（P=0.005）。结论 MMG比US在诊断活检术后残瘤灶准确性更高。

Objective To prospectively evaluate the relative accuracies of mammography（ MMG） and ultrasound（ US）in predicting residual lesions in breast cancer patients following bioptic lumpectomy. Methods From August 2013 to October 2016,215 patients with primary breast cancer confirmed by surgical biopsy were enrolled. All the patients underwent re-excision mastectomy or lumpectomy. Surgical pathology as the gold standard,the MMG and US imaging results were compared. Results Residual disease was identified in 138 patients（ 64. 19%） after the second operation,included 63（ 45. 65%） patients underwent ductal carcinoma in situ（ DCIS）. The sensitivity and accuracy of MMG in estimating residual lesions were 65. 94% and 72. 56%,which was higher than that of US（ 32. 61% and 53. 95%,respectively）,and there was a significant difference between them（ P = 0. 005）. Conclusion MMG was more accurate compared with US in detecting residual disease following bioptic lumpectomy.