超声BI-RADS分级在社区女性乳腺癌筛查中的应用与探讨

Application and discussion of ultrasound BI-RADS grading in community women breast cancer screening

目的:分析社区女性乳腺癌筛查中超声BI-RADS分级的应用价值。方法:选取2018年6月-2019年12月在社区卫生服务中心进行乳腺检查的女性1 677例,进行超声BI-RADS分级;经手术病理证实为乳腺癌240例,分析超声BI-RADS分级与患者病理结果的相关性。结果:不同BI-RADS分级中,病灶血流RI值、钙化、方位、周围组织、边界、形态、病灶边缘等方面比较,差异有统计学意义(P<0.05);而病灶血管分布的不同分级比较,差异无统计学意义(P>0.05)。筛选BI-RADS分级3~5级患者195例(250个病灶),其中良性病变58例、恶性病变137例;社区乳腺癌超声BI-RADS分级诊断中,敏感度为92.70%,特异度为86.21%。恶性病变137例中,BI-RADS 3级患者的恶性率为16.67%;4级恶性率为88.89%,5级恶性率为100.00%。结论:在社区女性乳腺癌筛查中超声BI-RADS分级诊断,具有较高的特异性与敏感性,为临床提供了有效依据,且乳腺癌恶性率与超声BI-RADS分级呈正相关。

Objective:To analyze the application value of ultrasound BI-RADS grading in breast cancer screening of community women.Methods:From June 2018 to December 2019,1677 women who underwent breast examination in community health service centers were selected and they received ultrasound BI-RADS classification.240 cases of breast cancer were confirmed by operation and pathology.The correlation between BI-RADS grading and pathological results was analyzed.Results:In different BI-RADS grading,there were significant differences in RI value,calcification,orientation,surrounding tissue,boundary,morphology and lesion edge(P<0.05).However,there was no significant difference in different grades of vascular distribution in lesions(P>0.05).A total of 195 patients(250 lesions)with BI-RADS grade 3 to 5 were selected,there were 58 cases of benign lesions and 137 cases of malignant lesions.In the grading diagnosis of breast cancer by BI-RADS in community,the sensitivity and specificity were92.70%and 86.21%respectively.In 137 cases of malignant lesions,the malignant rate of BI-RADS grade 3 was 16.67%,that of grade 4 was 88.89%,and that of grade 5 was 100.00%.Conclusion:Ultrasound BI-RADS classification has high specificity and sensitivity in breast cancer screening of community women,it provides an effective basis for clinical practice.The malignant rate of breast cancer was positively correlated with BI-RADS grading.