乳腺钼靶X线诊断与凝血指标鉴别乳腺良恶性病变的价值

Value of Molybdenum Target X-ray Diagnosis and Coagulation Index in Differentiating Benign and Malignant Breast Lesions

目的探讨乳腺钼靶X线诊断与凝血指标鉴别乳腺良恶性病变的价值。方法以2018.4~2021.4收治的80例乳腺病变患者为对象,均接受乳腺钼靶检查。检测患者凝血指标,分析其鉴别乳腺病变性质的价值。结果80例患者经手术病理确诊为乳腺癌46例,乳腺良性病变34例。恶性组活化部分凝血活酶时间(aPTT)、凝血酶原时间(PT)水平低于良性组,纤维蛋白原(Fbg)水平高于良性组(P<0.05)。aPTT、PT、Fbg诊断乳腺恶性病变的AUC分别为0.643(95%CI:0.528~0.747)、0.927(95%CI:0.847~0.973)、0.789(95%CI:0.683~0.872)。凝血指标诊断乳腺癌的灵敏度、特异度、准确度分别为91.30%、88.24%、90.00%;乳腺钼靶诊断乳腺癌的灵敏度、特异度、准确度分别为82.61%、82.35%、82.50%;联合检测诊断乳腺癌的灵敏度、特异度、准确度分别为97.83%、94.12%、96.25%。联合检测诊断乳腺癌的准确度高于凝血指标及乳腺钼靶(P<0.05)。结论乳腺恶性病变患者患者凝血功能亢进明显,与乳腺钼靶X线联合鉴别乳腺疾病性质的价值较高。

Objective To explore the value of breast molybdenum target X-ray diagnosis and coagulation indexes in differentiating benign and malignant breast lesions.Methods 80 patients with breast lesions treated from April 2018 to April 2021 were examined by mammography.To detect the coagulation indexes of patients and analyze their value in differentiating the nature of breast lesions.Results The 80 patients,46 were diagnosed as breast cancer and 34 with benign breast lesions.The levels of activated partial thromboplastin time(aPTT)and prothrombin time(PT)in malignant group were lower than those in benign group,and the level of fibrinogen(FBG)was higher than those in benign group(P<0.05).The AUCs of appt,Pt and FBG in the diagnosis of breast malignant lesions were 0.643(95%CI:0.528~0.747),0.927(95%CI:0.847~0.973)and 0.789(95%CI:0.683~0.872),respectively.The sensitivity,specificity and accuracy of coagulation markers in diagnosing breast cancer were 91.30%,88.24%and 90%respectively.The sensitivity,specificity and accuracy of mammography in diagnosing breast cancer were 82.61%,82.35%and 82.50%respectively.The sensitivity,specificity and accuracy of combined detection for breast cancer were 97.83%,94.12%and 96.25%respectively.The accuracy of combined detection for breast cancer is higher than that of coagulation index and mammography(P<0.05).Conclusion Patients with malignant breast lesions have obvious hypercoagulability.It is of high value to identify the nature of breast diseases combined with breast molybdenum target X-ray.