乳腺专用伽玛显像在亚洲女性乳腺癌诊断中的准确性评价

Accuracy evaluation of breast-specific gamma imaging in the diagnosis of breast cancer in Asian women

目的评价乳腺专用伽玛显像(BSGI)在亚洲女性人群乳腺癌诊断中的应用价值。方法收集24例同时接受BSGI和磁共振乳房成像(MRM)检查的乳腺疾病病例,以组织病理学结果为金标准,计算BSGI和MRM诊断乳腺癌的敏感度和特异度。检索有关BSGI和MRM用于亚洲女性乳腺癌诊断的研究,连同上述队列资料一起合并计算敏感度、特异度及诊断比值比(DOR),进行系统评价。结果基于浙江大学附属第二医院长兴院区的数据,BSGI诊断乳腺癌的敏感度为0.88(95%CI 0.64~0.99),特异度为0.86(95%CI 0.42~1.00);MRM的敏感度为0.82(95%CI 0.57~0.96),特异度为0.57(95%CI 0.18~0.90)。系统评价共纳入合格研究6项,共计研究对象633人,BSGI及MRM诊断亚洲女性乳腺癌合并敏感度分别为0.78(95%CI 0.74~0.82)和0.89(95%CI 0.86~0.92),合并特异度分别为0.85(95%CI 0.79~0.89)和0.55(95%CI 0.47~0.63),DOR分别为21.08(95%CI 8.10~54.84)和14.49(95%CI 6.67~31.47)。结论 BSGI有助于提高亚洲女性乳腺癌早期诊断水平。

Objective To evaluate the application value of breast-specific gamma imaging （BSGI） in the diagnosis of breastcancer in Asian women.Methods Totally 24 cases of breast disease who were examined by BSGI and magnetic resonancemammography（MRM）were selected. The histopathological results as the gold standard, the sensitivity and specificity ofBSGI and MRM in the diagnosis of breast cancer were calculated. The studies about BSGI and MRM in the diagnosis of breastcancer in Asian women were retrieved, and the sensitivity, specificity and diagnostic odds ratios（DOR）were evaluated bymeta analysis.Results The data of Changxing branch of the second affiliated hospital of Zhejiang university indicated thesensitivity of BSGI in diagnosis of breast cancer was 0.88（95%CI 0.64～0.99）,the specificity was 0.86（95%CI 0.42～1.00）.The sensitivity of MRM in diagnosis of breast cancer was 0.82（95%CI 0.57～0.96）, and the specificity was 0.57（95%CI0.18～0.90）.The systematic evaluation included 6 eligible studies,including a total of 633 subjects. The combinedsensitivities of BSGI and MRM in the diagnosis of breast cancer in Asian women were 0.78（95%CI 0.74～0.82）and 0.89（95%CI 0.86～0.92）respectively ,the combined specificities were 0.85（95%CI 0.79～0.89）and 0.55（95%CI 0.47～0.63）respectively, the DORs were 21.08（95%CI 8.10～54.84）and 14.49（95%CI 6.67～31.47）respectively.Conclusion BSGIis benefit for early diagnosis of breast cancer in Asian women.