超声弹性成像和钼靶X线对乳腺浸润性导管癌的诊断价值研究

The Value of Ultrasound Elastography and Molybdenum Target X-ray in the Diagnosis of Breast Invasive Ductal Carcinoma

背景乳腺癌是女性常见的恶性肿瘤之一,寻找有效的乳腺癌早期诊断方法非常重要。目的探究超声弹性成像、钼靶X线对乳腺浸润性导管癌的诊断价值。方法选取2017年10月—2019年12月于安徽皖北煤电集团总医院就诊的女性疑似乳腺浸润性导管癌患者102例为研究对象,术前或穿刺活检前均行超声弹性成像、钼靶X线检查,以病理诊断为金标准。分析乳腺浸润性导管癌组织学分级与超声弹性成像评分的相关性。绘制超声弹性成像、钼靶X线诊断乳腺浸润性导管癌的受试者工作特征(ROC)曲线。结果最终经金标准确诊为乳腺浸润性导管癌者98例。乳腺浸润性导管癌组织学分级与超声弹性成像评分呈正相关(r_(s)=0.452,P=0.003)。当超声弹性成像评分最佳截断值为4分时,其诊断乳腺浸润性导管癌灵敏度为88.1%,特异度为92.1%,ROC曲线下面积(AUC)为0.953〔95%CI(0.912,0.995)〕;当钼靶X线最佳截断值为4b级时,其诊断乳腺浸润性导管癌的灵敏度为72.4%,特异度为83.3%,AUC为0.855〔95%CI(0.805,0.893)〕;超声弹性成像诊断乳腺浸润性导管癌的AUC大于钼靶X线(Z=3.337,P<0.05)。结论超声弹性成像对乳腺浸润性导管癌的诊断价值较钼靶X线高,且超声弹性成像与乳腺浸润性导管癌组织学分级呈正相关,对临床评估乳腺浸润性导管癌恶性程度有重要意义。

Background Breast cancer is one of the most common malignant tumors in women,so it is extremely important to find an effective method for early diagnosis of breast cancer.Objective To investigate the value of ultrasonic elastography and molybdenum target X-ray in the diagnosis of breast invasive ductal carcinoma.Methods From October 2017 to December 2019,102 female patients with suspected breast invasive ductal carcinoma treated in the Wanbei Coal Electricity Group General Hospital were selected as research objects.Ultrasonic elastography and molybdenum target X-ray examination were performed before operation or biopsy,with pathological diagnosis as the gold standard.The correlation between histological grade and ultrasonic elasticity score of breast invasive ductal carcinoma was analyzed.The ROC curves of ultrasound elastography and molybdenum target X-ray in the diagnosis of breast invasive ductal carcinoma were drawn.Results 98 cases of invasive ductal carcinoma of breast were confirmed by the gold standard.The histological grade of breast invasive ductal carcinoma was positively correlated with ultrasonic elasticity score(r_(s)=0.452,P=0.003).When the optimal cutoff value of ultrasound elastography was 4,the sensitivity,specificity and AUC in diagnosis of breast invasive ductal carcinoma were 88.1%,92.1%and 0.953〔95%CI(0.912,0.995)〕;when the optimal cutoff value of molybdenum target X-raywas 4b,the sensitivity,specificity and AUC in diagnosis of breast invasive ductal carcinoma were 72.4%,83.3%and 0.855〔95%CI(0.805,0.893)〕.AUC of ultrasound elastography in the diagnosis of breast invasive ductal carcinoma was higher than that of molybdenum target X-ray(Z=3.337,P<0.05).Conclusion The diagnostic value of ultrasound elastography is higher than molybdenum target X-ray in the diagnosis of breast invasive ductal carcinoma,and ultrasound elastography is positively correlated with the histological grade of breast invasive ductal carcinoma,which is greatly significant in the evaluation of maligant degree of clinical diagnosis of breast invasive ductal carcinoma.