超声、超声造影和X线钼靶联合诊断在早期乳腺癌中的应用

Diagnostic value of ultrasonography,contrast-enhanced ultrasonography and X-ray mammography in early-stage breast cancer

目的:探讨超声、超声造影、X线钼靶及三者联合应用对早期乳腺癌的诊断价值。方法:收集行超声、超声造影、X线钼靶及三者联合诊断的156例乳腺癌和260例乳腺良性病变患者的病例资料,统计分析超声、超声造影、X线钼靶3种检查方法单独及联合使用对早期乳腺癌诊断率的差异。结果:超声单独诊断早期乳腺癌敏感度、特异度、假阳性率、假阴性率、符合率分别为86.55%、58.25%、41.75%、13.45%、68.62%;超声造影单独诊断早期乳腺癌,敏感度、特异度、假阳性率、假阴性率、符合率分别为93.10%、70.73%、29.27%、6.89%、77.90%;X线钼靶单独诊断早期乳腺癌敏感度、特异度、假阳性率、假阴性率、符合率分别为64.00%、66.32%、33.67%、36.00%、65.32%;三者联合使用诊断早期乳腺癌敏感度、特异度、假阳性率、假阴性率、符合率分别为92.30%、98.40%、1.58%、7.69%、96.62%。单独应用超声造影诊断准确度高于单独应用超声及X线钼靶,差异有统计学意义(P<0.05);三者联合应用的诊断准确度均高于单独应用超声、超声造影、X线钼靶,差异有统计学意义(P<0.05)。结论:单独应用超声造影诊断早期乳腺癌诊断符合率高于单独应用超声及X线钼靶。三者联合应用可以提高诊断早期乳腺癌的准确度,对于早期乳腺癌的早诊断、早治疗有重要临床意义。

Objective:To investigate the diagnostic value of ultrasonography,contrast-enhanced ultrasonography and X-ray mammography in early-stage breast cancer.Methods:The clinical and imaging data of 156 patients with breast cancer and 260 patients with benign tumor of breast who underwent ultrasonography,contrast enhanced ultrasonography as well as X-ray mammography were retrospectively analyzed.The respective and combined diagnostic rates of ultrasonography,contrast-enhanced ultrasonography and X-ray mammography were evaluated and differences among them were discussed.Results:The sensitivity,specificity,false positive rate,false negative rate and coincidence rate respectively were 86.55%,58.25%,41.75%,13.45%and 68.62%for ultrasonography in 103 early-stage breast cancer patients.While,the sensitivity,specificity,false positive rate,false negative rate and coincidence rate respectively were 93.10%,70.73%,29.27%,6.89%and 77.90%for contrast-enhanced ultrasonography in 54 patients with early-stage breast cancer.For 96 patients who underwent X-ray mammography,the sensitivity,specificity,false positive rate,false negative rate and coincidence rate respectively were 64.00%,66.32%,33.67%,36.00%and 65.32%.The combined diagnosis with ultrasonography,contrast-enhanced ultrasonography and X-ray mammography showed sensitivity,specificity,false positive rate,false negative rate and coincidence rate respectively with 92.30%,98.40%,1.58%,7.69%and 96.62%.The diagnostic accuracy rate is higher in contrast-enhance ultrasonography alone than ultrasonography and X-ray mammography alone(P<0.05).The combined diagnostic rate was higher than single use of ultrasonography,contrast-enhanced ultrasonography and X-ray mammography.Conclusion:Contrast-enhanced ultrasonography showed higher diagnostic rate in patients with early-stage breast cancer than ultrasonography and X-ray mammography.Combined diagnosis improved the diagnostic rate in patients with early-stage breast cancer,thus,play a crucial role in early diagnosis and treatment of early-stage breast cancer.