早期乳腺癌超声误诊和漏诊原因分析

Analysis of misdiagnosis and missed diagnosis of early breast cancer by ultrasound

目的分析早期乳腺癌超声误诊和漏诊原因,总结超声诊断经验。方法选择2016年1月-2018年6月医院行超声检查的早期乳腺癌筛查患者114例,其中误诊和漏诊33例(误漏诊组,乳腺癌漏诊为良性病变20例,良性疾病误诊为乳腺癌13例),超声诊断最终确诊早期乳腺癌81例为确诊组。采用回顾性分析,比较各组超声特征、年龄、症状。结果漏诊患者超声表现不规则、小分叶、强声晕、腺体结构紊乱占比与确诊患者比较差异均有统计学意义(P<0.05)。漏诊与确诊患者血流分型比较差异有统计学意义(P<0.05)。漏诊患者不规则率低于误诊患者,差异有统计学意义(P<0.05);漏诊与误诊患者小分叶、强声晕、腺体结构紊乱比较差异无统计学意义(P>0.05)。误漏诊组与确诊组年龄、症状比较差异均有统计学意义(P<0.05)。结论早期乳腺癌超声误诊和漏诊与超声表现是否典型有关,不典型、不处于乳腺癌高发年龄段及无症状对超声医师检查有较大的影响。

Objective To analyze the causes of misdiagnosis and missed diagnosis of early breast cancer by ultrasound,and to summarize the experience of ultrasound diagnosis.Methods 114 patients with suspected early breast cancer who underwent ultrasound from January 2016 to June 2018 were selected, among them,33 cases of misdiagnosis and missed diagnosis(misdiagnosis and missed diagnosis group,20 cases of breast cancer misdiagnosed as benign lesions,13 cases of benign diseases misdiagnosed as breast cancer),81 cases of early breast cancer diagnosed by ultrasound as the confirmed group.Retrospective analysis was performed to compare the characteristics,age,and symptoms of ultrasound in each group.Results There were significant differences in the proportion of irregular ultrasonographic manifestations,lobulation,halo and gland structure disorders between missed diagnosis and early breast cancer patients(P<0.05).There was significant difference in blood flow pattern between the missed patients and the confirmed early breast cancer patients(P<0.05).The irregularity rate of missed patients was lower than that of misdiagnosed patients,and the difference was statistically significant(P<0.05).There was no significant difference in the proportion of lobulation,halo and gland structure disorders between missed diagnosis and misdiagnosis patients(P>0.05).There were significant differences in age and symptoms between misdiagnosis and missed diagnosis group and confirmed group(P<0.05).Conclusion The misdiagnosis and missed diagnosis of early breast cancer by ultrasound is related to whether the ultrasound manifestation is typical or not,atypical,not in the age group with high incidence of breast cancer,and asymptomatic also have a great influence on ultrasound examination.