血清IL⁃1β、sE⁃cad、E2结合乳腺超声在浆细胞性乳腺炎与乳腺癌鉴别诊断中的意义

The significance of serum IL⁃1β,sE⁃cad,E2 combined with breast ultrasound in the dif⁃ferential diagnosis of plasma cell mastitis and breast cancer

目的探讨血清IL⁃1β、sE⁃cad、E_(2)结合乳腺超声在浆细胞性乳腺炎与乳腺癌鉴别诊断中的意义。方法选取2020年4月至2023年11月间德阳市人民医院乳腺科首次入院且未经治疗的住院患者为研究对象,基于乳腺彩超BI⁃RADS分类标准,筛选出BI⁃RADS 4类及以上的患者,并进一步依据其乳腺癌(BC)术后病理学诊断报告,确认105例BC患者,并归为BC组。同时,随机抽取乳腺彩超BI⁃RADS 3类及以下、诊断为浆细胞性乳腺炎(PCM)的患者95例,归为PCM组。所有研究对象均行乳腺超声检查。比较两组血清IL⁃1β、sE⁃cad、E_(2)水平、乳腺超声形态学表现及参数;绘制ROC曲线,分析血清IL⁃1β、sE⁃cad、E_(2)结合乳腺超声在BC与PCM鉴别诊断中的价值。结果BC组血清IL⁃1β、sE⁃cad、E_(2)水平、V max、RI及PI显著高于PCM组,差异有统计学意义(P<0.05)。两组位置、大小、边缘特征、有无微钙化、有无后方衰减、有无侧方声影及纵横比比较,差异有统计学意义(P<0.05);而两组边界清晰度、内部回声状态比较,差异无统计学意义(P>0.05)。血清IL⁃1β、sE⁃cad、E_(2)结合乳腺超声在BC与PCM鉴别诊断中的AUC(95%CI)、灵敏度及特异度分别为0.933(0.863⁃0.966)、94.26%、91.77%;显著高于血清IL⁃1β、sE⁃cad、E_(2)、乳腺超声单一诊断(P<0.05)。结论血清IL⁃1β、sE⁃cad、E_(2)结合乳腺超声可显著提高BC与PCM的鉴别诊断准确性,有助于临床早期发现与精确治疗,对优化患者管理和提高治疗效果具有重要意义。

Objective To investigate the significance of serum IL⁃1β,sE⁃cad and E_(2) combined with breast ultrasound in the differential diagnosis of plasma cell mastitis and breast cancer.Methods The patients who were initially admitted to the Department of Mammary Glands of Deyang People's Hospital from April 2020 to November 2023 and had not received treatment were selected as the research subjects.Using the BI⁃RADS classification criteria for breast color Doppler ultrasound,patients with a BI⁃RADS score of 4 or higher were identified.Based on the postoperative pathological diagnosis of breast cancer(BC),105 patients were confirmed to have BC and were categorized as the BC group.At the same time,95 patients with a breast ultrasound BI⁃RADS score of 3 or lower,diagnosed with plasma cell mastitis(PCM)were randomly selected and placed in the PCM group.All subjects underwent a breast ultrasound examination.The levels of serum IL⁃1β,sE⁃cad and E_(2),the ultrasonographic features and parameters of breast were compared between the two groups.An ROC curve was drawn to analyze the value of serum IL⁃1β,sE⁃cad,E_(2) combined with breast ultrasound in the differential diagnosis between BC and PCM.Results The levels of serum IL⁃1β,sE⁃cad,E_(2),Vmax,RI and PI in the BC group were significantly higher than those in the PCM group(P<0.05).There were significant differences in location,size,edge characteristics,microcalcification,posterior attenuation,lateral acoustic shadow and aspect ratio between the two groups(P<0.05).There was no significant difference in boundary clarity and internal echo status between the two groups(P>0.05).The AUC(95%CI),sensitivity and specificity of IL⁃1β,sE⁃cad,E_(2) combined with breast ultrasound in the differential diagnosis of BC and PCM were 0.933(0.863⁃0.966),94.26%and 91.77%,respectively,significantly higher than serum IL⁃1β,sE⁃cad,E_(2),breast ultrasound single diagnosis(P<0.05).Conclusion E_(2) combined with breast ultrasound can significantly improve the accuracy of differential diagnosis between BC and PCM.This is beneficial for early clinical detection and precise treatment,and is crucial for optimizing patient care and enhancing treatment outcomes.