超声组学对BI-RADS 4类乳腺良恶性病变的鉴别诊断价值

Differential diagnostic value of ultrasomics in benign and malignant breast lesions of BI-RADS category 4

目的探讨超声组学对BI-RADS 4类乳腺良恶性病变的鉴别诊断价值。方法前瞻性收集我院经穿刺活检病理证实的BI-RADS 4类乳腺病变患者223例,分为训练样本114例(良性81例,恶性33例)和验证样本109例(良性70例,恶性39例)。基于训练样本建立乳腺病变的超声组学评分指标。绘制受试者工作特征(ROC)曲线,定量评估超声组学评分鉴别BI-RADS 4类乳腺病变良恶性的诊断效能,计算其敏感性和特异性;并于验证样本中验证其诊断效能。结果纳入的223例病例中,恶性比例为32.29%。训练样本和验证样本的恶性比例分别为28.95%、35.78%。超声组学评分在训练样本和验证样本的曲线下面积及其95%可信区间分别为0.826(0.743~0.909)和0.810(0.723~0.898)。在训练样本中,超声组学评分鉴别BI-RADS 4类乳腺病变良恶性的敏感性和特异性分别为78.79%和81.48%;在验证样本中,其对应的敏感性和特异性分别为66.67%和82.86%。结论超声组学评分在鉴别BI-RADS 4类乳腺良恶性病变中有一定诊断价值。

ObjectiveTo explore the value of ultrasomics in differential diagnosis of benign and malignant breast lesions of BI-RADS category 4.MethodsA total of 223 patients with breast lesions of BI-RADS category 4 confirmed by biopsy pathology in our hospital were collected prospectively,and they were divided into the training group(n=114,81 benign cases and 33 malignant cases)and validation group(n=109,70 benign cases and 39 malignant cases).The ultrasomics score of breast lesion was established based on the training group.Receiver operating characteristic(ROC)curve of the ultrasomics score was drawn to quantitatively assess the differential diagnostic efficacy of benign and malignant breast lesions of BI-RADS category 4,the sensitivity and specificity were calculated and verified in the validation group.ResultsAmong the223 cases,malignancy accounted for 32.29%.The malignant proportions in the training and validation groups were 28.95%and 35.78%,respectively.The AUC with 95%confidence interval of the ultrasomics score in the training and validation groups were 0.826(0.743~0.909)and 0.810(0.723~0.898),respectively.In the training group,the sensitivity and specificity of ultrasomics scores to distinguish benign and malignant breast lesions of BI-RADS category 4 lesions were 78.79%and81.48%,respectively.In the validation group,the corresponding sensitivity and specificity were 66.67%and 82.86%,respectively.ConclusionThe ultrasomics score has a certain value in differential diagnosis of breast lesions of BI-RADS category 4.