ABVS联合二维超声在乳腺癌诊断中的应用

Application of ABVS combined with two-dimendional ultrasound in the diagnosis of breast cancer

目的探讨全自动乳腺容积检查(ABVS)联合二维超声成像对乳腺恶性肿瘤的诊断价值。方法自2019年5月—2021年9月共100例患者(110个病灶)因乳腺肿物在新疆医科大学第五附属医院接受二维超声和ABVS检查,所有患者均经病理学检查。分析二维超声、ABVS检查和ABVS联合二维超声乳腺影像报告和数据系统(BI-RADS)分类对乳腺病灶的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比,绘制受试者工作特征(ROC)曲线。结果110个病灶病理检查结果:恶性53个,良性57个。不同方法诊断乳腺良恶性病灶的效能:二维超声灵敏度71.70%、特异度78.95%、阳性预测值76.00%、阴性预测值75.00%、阳性似然比3.406、阴性似然比0.358;ABVS灵敏度84.91%、特异度96.49%、阳性预测值95.74%、阴性预测值87.30%、阳性似然比24.199、阴性似然比0.156;ABVS联合二维超声BI-RADS分类检查的灵敏度94.34%、特异度92.98%、阳性预测值92.59%、阴性预测值94.64%、阳性似然比13.443、阴性似然比0.061。根据ROC曲线计算曲线下面积(AUC,二维超声为0.791,ABVS为0.866,ABVS联合二维超声检查为0.884)。结论ABVS对乳腺恶性肿瘤的诊断具有良好的临床应用价值;ABVS联合二维超声进行BI-RASDS分类时,能够弥补二维声像图的不足之处,可提高对乳腺恶性肿瘤的检出率。

Objective To evaluate the diagnostic value of automatic breast volume examination(ABVS)combined with two-dimensional(2-D)ultrasound imaging of breast malignant tumor.Methods From May 2019 to September 2021,a total of 100 patients(110 lesions)underwent two-dimensional ultrasound and ABVS examination for breast masses in the hospital,and all patients obtained pathological results.The sensitivity,specificity,positive predictive value,nega⁃tive predictive value,positive likelihood ratio and negative likelihood ratio of two-dimensional ultrasound,ABVS and ABVS combined 2-D ultrasound breast imaging Report and Data System(BI-RADS)classification of breast lesions were analyzed,and the receiver operating characteristic(ROC)curve was drawn.Results The pathological examina⁃tion results of 110 lesions showed that 53 were malignant and 57 were benign.The effectiveness of different methods for diagnosis of benign and malignant breast lesions was as follows:2-D ultrasound sensitivity 71.70%,specificity 78.95%,positive predictive value 76.00%,negative predictive value 75.00%,positive likelihood ratio 3.406,negative likelihood ratio 0.358;ABVS sensitivity 84.91%,specificity 96.49%,positive predictive value 95.74%,negative pre⁃dictive value 87.30%,positive likelihood ratio 24.199,negative likelihood ratio 0.156;The sensitivity,specificity,posi⁃tive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio of ABVS com⁃bine two-dimensional ultrasonic BI-RADS classification were 94.34%,92.98%,92.59%,94.64%,13.443 and 0.061.The area under the curve(AUC)was calculated according to the ROC curve(2-D ultrasound=0.791,ABVS=0.866,AB⁃VS combine two-dimensional ultrasonic=0.884).Conclusion ABVS has good clinical application value in the diagno⁃sis of breast malignant tumor.When ABVS combined with two-dimensional ultrasound was used for BI-RASDS classi⁃fication,it could make up for the deficiency of two-dimensional acoustic image pair and improve the detection rate of breast malignant tumor.