超声和PET/CT定性及定量指标联合应用在乳腺癌诊断中的价值

Value of the combination of qualitative and quantitative indicators from ultrasound and PET/CT in diagnosing breast cancer

目的探讨超声或正电子发射断层显像/X线计算机体层成像(PET/CT)检查单独或联合应用在乳腺癌诊断中的应用价值。方法选取同期行超声检查和PET/CT检查且均获得术后病理确诊的90例乳腺肿块,根据肿瘤性质分为恶性组(n=60)及良性组(n=30),比较2组患者超声检查指标[肿瘤大小、形态、边界、分叶、钙化、阻力指数(RI)及转移淋巴结]和PET/CT检查指标[肿瘤大小、形态、边界、毛刺、密度、最大标准化摄取值(SUV max)及转移淋巴结]的差异;用有统计学差异的指标建立Logistic回归模型,用Hosmer-Lemeshow检验模型的拟合效果,绘制受试者工作特征曲线(ROC),以ROC曲线下面积(AUC)评价超声和PET/CT定性及定量指标(单独超声、单独超声指标联合、单独PET/CT指标、单独PET/CT指标联合及超声与PET/CT指标总联合)对乳腺癌的诊断效能。结果两组患者超声的大小、形态、边界、RI及转移淋巴结指标和PET/CT的大小、形态、毛刺、密度、边界、SUV max及转移淋巴结指标比较,差异有统计学意义(P<0.05);超声和PET/CT总指标联合的AUC(0.999)高于超声单独指标联合(0.914)或PET/CT单独指标联合的AUC(0.994),差异有统计学意义(P<0.05)。结论超声和PET/CT定性及定量指标联合应用对乳腺癌诊断效能高于单一的超声单独指标联合或PET/CT单独指标联合。

Objective To explore diagnostic efficacy of ultrasound or positron emission tomography/X-ray computed tomography(PET/CT)examination alone or their combination in diagnosing breast cancer.Methods Ninety breast lumps from patients with breast cancer that underwent ultrasound examination and PET/CT examination and were pathologically confirmed after surgery during the same period were selected.According to the nature of the tumor,these patients were divided into malignant group(n=60)and benign group(n=30).Ultrasound inspection indicators[tumor size,shape,boundary,lobules,calcification,resistance index(RI)and metastatic lymph nodes]and PET/CT inspection indicators[tumor size,shape,boundary,burr,density,maximum standardized uptake value(SUVmax)and metastatic lymph nodes]were compared between the two groups.A Logistic regression model was established by using statistically different indicators.Hosmer-Lemeshow was used to examine the fitting effect of the model.A receiver operating characteristic curve(ROC)was drawn,and the area under the ROC curve(AUC)values were used to evaluate diagnostic accuracy of ultrasound and PET/CT qualitative and quantitative indicators(ultrasound alone,combined indicators of ultrasound alone,PET/CT alone,combined indicators of PET/CT alone,a combined indicators of ultrasound and PET/CT)in diagnosing breast cancer.Results The size,shape,boundary,RI,and metastatic lymph node indexes determined by ultrasound,and size,shape,burr,density,boundary,SUVmax,and metastatic lymph node indexes determined by PET/CT were statistically,significantly different between two groups(P<0.05).Ultrasound combined with PET/CT had AUC with 0.999,which was higher than ultrasound alone with AUC(0.914)or PET/CT alone with AUC(0.994,P<0.05).Conclusion Qualitative and quantitative indicators from the ultrasound combined with PET/CT are more effective in diagnosing breast cancer than combined indicators from ultrasound alone or combined indicators from PET/CT alone.