超声引导下粗针穿刺活检与常规超声检查诊断乳腺癌的效果比较

Ultrasound-guided needlebiopsy versus routine ultrasound examination in diagnosis of breast cancer

目的对比超声引导下粗针穿刺活检(UGCNB)与常规超声(US)检查在乳腺癌诊断中的价值。方法对82例拟诊为乳腺癌患者的临床资料进行回顾性分析,患者均接受UGCNB及US检查,观察乳腺良恶性病变超声表现差异。以手术病理结果为金标准,评估UGCNB及US检查对乳腺癌诊断的灵敏度(SE)、特异度(SP)、准确度(AC)、阳性预测值(PPV)及阴性预测值(NPV),比较两者对乳腺癌的诊断价值。结果82例患者中,乳腺癌58例,乳腺良性病变24例。乳腺癌的超声图像主要表现为形态不规则,边界欠清晰,内部回声粗杂不均匀,后方回声衰减,常见微钙化,包膜不光整,血流信号多为Ⅱ~Ⅲ级,与乳腺良性病变比较有显著差异(P<0.01)。UGCNB诊断乳腺癌的SE、SP、AC、PPV、NPV显著高于US检查(P<0.05或P<0.01)。UGCNB与术后病理结果比较的Kappa值大于US检查。US检查与UGCNB诊断乳腺癌的关联性和优势性均有显著差异(P<0.05)。结论乳腺良恶性病变的超声表现差异显著,UGCNB对乳腺癌的诊断效能优于US检查,对提高乳腺癌诊断AC有重要意义。

Objective To compare the value of ultrasound-guided needle biopsy(UGCNB)versus routine ultrasound(US)in diagnosis of breast cancer.Methods The clinical data of 82 patients with probable breast cancer diagnosed in our hospital was retrospectively analyzed.All patients underwent US and UGBNB examinations,and the differences in ultrasound findings between benign and malignant breast lesions were observed.The surgical pathology results were taken as gold standards to evaluate the sensitivity(SE),specificity(SP),accuracy(AC),positive predictive value(PPV)and negative predictive value(NPV)of UGCNB and US in diagnosis of breast cancer,and the diagnostic value of two methods was compared.Results Of the 82 patients,58 cases were diagnosed as breast cancer and 24 cases as benign breast lesions.Ultrasound images of breast cancer were mainly characterized by irregular shape,unclear boundary,coarse and heterogeneous internal echo,posterior echo attenuation,common microcalcification,non-smooth capsule and most blood flow signals of gradeⅡ~Ⅲ,which showed significant differences when compared to the ultrasound findings of benign breast lesions(P<0.01).The SE,SP,AC,PPV and NPV of UGCNB in the diagnosis of breast cancer were higher than those of US(P<0.05 or P<0.01).Compared with postoperative pathology results,UGCNB showed a higher Kappa value than US.There were statistically significant differences in the relevance and superiority between US and UGWNB in the diagnosis of breast cancer(P<0.05).Conclusion There are significant differences in ultrasound findings between benign and malignant breast lesions.UGCNB has better diagnostic efficacy than US in the diagnosis of breast cancer,and it is of great significance in improving the diagnostic accuracy of breast cancer.