健康体检中女性乳腺结节样病变超声评估等级分析

Ordinal analysis on ultrasonographic classification of female breast nodules in physical examination

目的探讨健康体检女性人群中乳腺结节样病变相关影响因素及超声分级评估的意义,为早期发现和预防乳腺癌提供有效的依据。方法收集2012-2017年在绍兴市人民医院健康体检中心体检并具有完整信息的2 615名成年女性的体检资料,进行超声BI-RADS分级及单因素Logistic回归分析和多因素Logistic回归分析。结果 2 615名女性中,发现乳腺结节样病变的阳性病人646例,总检出率为24.7%。对各年龄组BI-RADS分级评估2~5级的百分比进行比较,差异有统计学意义(P<0.01)。不同年龄组女性比较,乳腺结节样病变检出率差异有统计学意义(P<0.01)。单因素Logistic回归分析提示,年龄、TC、TG等是乳腺结节样病变发病的影响因素。多因素Logistic回归分析提示,年龄、体重、TC是乳腺结节样病变的综合影响因素。结论对健康体检女性人群超声检查中乳腺结节样病变评估BI-RADS 2~5级进行分析,育龄期女性随着年龄增长,在BI-RADS分级上越来越集中于3~4级。对BI-RADS分级3级以上人员的后期管理和随访对乳腺癌的早期发现和早期治疗有重要意义。

Objective To explore the related factors of breast nodular lesions in healthy female population and the signficance of ultrasound grading assessment,provide effective basis for early detection and prevention of breast cancer.Methods A retrospective analysis was made of 2 615 healthy adult women with complete information in the health examination center of in Shaoxing People’s hospital from 2012 to 2017.Ultrasound BI-RADS grading,univariate logistic regression analysis and multivariate logistic regression analysis were performed.Results Among 2 615 women,646 were positive,with a total detection rate of 24.7%.The number and percentage of BI-RADS grade 2~5 in each age group were counted and compared.The difference was statistically significant(P<0.01).In different age group,there was no significant difference in the detection rate of nodular lesions of breast.Univariate logistic regression analysis indicated that age,TC,TG and other factors were high risk factors for nodular breast lesions.Multivariate logistic regression analysis suggested that age,weight and lipid might be independent risk factors for breast nodular lesions.Conclusion The BI-RADS 2~5 grade of breast nodular lesions assessed by ultrasound in healthy population is analyzed statistically.The BI-RADS classification of women of childbearing age is more and more concentrated in grade 3~4 as they grow older.Post-management and follow-up of personnel with BI-RADS grade 3 or above play an important role in early detection and treatment of breast cancer.