常规超声与超声弹性成像检查对乳腺癌诊断价值分析

Analysis of the clinical value of conventional ultrasound and ultrasound elasticity in diagnosing breast cancer

目的分析常规超声与超声弹性成像检查对乳腺癌的诊断价值。方法回顾性分析本院2013年4月至2016年4月诊治的348例乳腺肿块患者的病历资料,所有患者均经常规超声与超声弹性成像检查进行诊断。将常规超声检查结果分为良性、不能确定及恶性。利用超声弹性成像检查对乳腺病灶软硬度进行评分,1~3分为良性,4~5分为恶性。设计两种联合诊断方式Com1与Com2,Com1仅在两种单项诊断均为良性时,联合诊断结果为良性;Com2仅在两种单项诊断结果均为恶性时,联合诊断结果为恶性。将诊断结果与病理诊断结果进行对比,比较单一检查与Com1、Com2诊断灵敏度、特异度及准确率的差异。结果 348例乳腺肿块患者中,良性病变246例,恶性病变102例。常规超声检查诊断灵敏度为84.31%,特异度为88.62%,准确率为87.36%;超声弹性成像检查诊断灵敏度为72.55%,特异度为86.18%,准确率为82.18%;Com1诊断灵敏度为94.12%,特异度为88.21%,诊断准确率为89.94%;Com2诊断灵敏度为80.39%,特异度为95.53%,准确率为91.09%。常规超声检查诊断灵敏度高于超声弹性成像(P<0.05),两种检查方法诊断特异度和准确率比较均无显著差异(P>0.05)。Com1在4种检查方法中诊断灵敏度最高(P<0.05),Com2诊断特异度最高(P<0.05)。结论常规超声与超声弹性成像检查鉴别乳腺良/恶性病变的原理不同,二者联合使用可弥补单一检查的不足,提高乳腺癌的诊断准确率。

Objective To analyze the value of conventional ultrasound(US)and ultrasound elasticity(UE)in the diagnosis of breast cancer.Method Retrospective analyzed the medical records of348cases of patients with breast abnormalities who were treated in our hospital from April2013to April2016.Patients were all diagnosed by US and UE.The diagnosis of US were divided into benign,uncertain and malignant.Breast lesions were graded by UE according to the organization hardness,scores from1to3points were assigned to the benign result,when scores from4to5points were assigned to the malignant result.Two joint diagnosis way design,which respectively were Com1and Com2.In Com1,only when both single diagnosis were benign,the result of joint diagnosis was benign.In Com2,only when both single diagnosis were malignant,the result of joint diagnosis was malignant.Compared the single diagnosis result and the pathological diagnosis.Calculated the sensitivity,speciality rate and diagnosis accuracy of individual diagnosis Com1and Com2.Result In the pathological diagnosis of348cases with breast abnormalities,246cases were diagnosed as benign lesion and102cases were diagnosed as malignant lesion.The sensitivity,speciality rate and diagnosis accuracy of US were84.31%,88.62%and87.36%.The sensitivity,speciality rate and diagnosis accuracy of UE were72.55%,86.18%and82.18%.In Com1,the sensitivity,speciality rate and diagnosis accuracy respectively were94.12%,88.21%and89.94%.In Com2,the sensitivity,speciality rate and diagnosis accuracy respectively were80.39%,95.53%and91.09%.Compared with UE,US had higher sensitivity(P<0.05).There were no significant differences in the speciality rate and diagnosis accuracy(P>0.05).Com1had the highest sensitivity in the4kinds of diagnosis(P<0.05).Com2had the highest speciality rate in the4kinds of diagnosis(P<0.05).Conclusion US and UE have different principle in identification of benign and malignant breast lesions.The combination of US and UE can make up the shortage of single diagnosis,improve the diagnostic accuracy for breast cancer.