超声造影定量参数对乳腺癌疾病分期的诊断价值探讨

Diagnostic Value of Quantitative Parameters of Contrast enhanced Ultrasound in the Staging of Breast Cancer

目的 探讨超声造影(CEUS)定量参数对乳腺癌(BC)疾病分期的诊断价值。方法 选取2019年1月至2022年6月在本院经病理学检查确诊为BC的135例患者为研究组,另选同时期在本院确诊为乳腺良性肿瘤的127例患者为对照组。2组患者均于入院当天进行CEUS检查,并通过时间-强度曲线(TIC)分析记录患者的CEUS定量参数[峰值强度(PI)、达峰时间(TTP)、上升支斜率、廓清时间(WOT)、曲线下面积(AUC)]。比较研究组与对照组患者的CEUS定量参数;另以病理学检查确定的BC疾病分期为“金标准”,比较不同临床分期BC患者的CEUS定量参数,绘制受试者工作特征(ROC)曲线分析超声参数单独及联合对BC疾病I-Ⅱ期与Ⅲ-IV期的鉴别诊断效能。结果 研究组的PI、上.升支斜率、WOT、AUC均.高于对照组(P<0.05),但TTP低于对照组(P<0.05)。I期、Ⅱ期、Ⅲ期、IV期BC患者的PI、上升支斜率.、WOT、AUC依次升高(P<0.05),而TTP依.次降低(P<0.05)。PI、TTP、上升斜率、W.OT、AUC联合诊断Ⅲ-IV期与I-Ⅱ期BC患者的灵敏度高于单项诊断(P<0.05),ROC曲线下面积高于单独诊断(P<0.05),特异度与单项诊断无统计学意义(P>0.05)。结论 CEUS定量参数(PI、TTP、上升支斜率、WOT、AUC)均可作为BC患者不同疾病分期的诊断指标,且其联合诊断效能更高。

Objective To explore the diagnostic value of quantitative parameters of contrast-enhanced ultrasound(CEUS)in the staging of breast cancer(BC).Methods 135 patients diagnosed as BC by pathology in our hospital from January 2019 to June 2022 were selected as the study group,and 127 patients diagnosed as benign breast tumors in our hospital in the same period were selected as the control group.The patients in both groups were examined by CEUS on the day of admission,and the quantitative parameters of CEUS[peak intensity(PI),time to peak(TTP),slope of ascending branch,wash out time(WOT),area under the curve(AUC)]were recorded by time-intensity curve(TIC)analysis.The quantitative parameters of CEUS were compared between the study group and the control group.In addition,taking the stage of BC disease determined by pathological examination as the gold standard,and the quantitative parameters of CEUS in different clinical stages of BC patients were compared,and the receiver operating characteristic(ROC)curves were drawn to analyze the differential diagnostic efficacy of ultrasound parameters alone and in combination for stages I-II and III-IV of BC disease.Results The PI,slope of ascending branch,WOT,AUC in the study group were higher than those in the control group(P<0.05),but TTP was lower than that in the control group(P<0.05).PI,slope of ascending branch,WOT,AUC of BC patients with stage I,II,III,IV increased in turn(P<0.05),but TTP decreased in turn(P<0.05).The sensitivity of joint diagnosis of PI,TTP,slope of ascending branch,WOT,AUC in the diagnosis of BC patients with stage III-IV and stage I-II was higher than that of single diagnosis(P<0.05),and the area under the curve of ROC was higher than the single diagnosis(P<0.05),while the the specificity was not statistically different from the single diagnosis(P>0.05).Conclusion Quantitative parameters of CEUS(PI,TTP,slope of ascending branch,WOT,AUC)can be used as diagnostic indicators for different disease stages of BC patients,and the joint diagnostic effectiveness of them is higher.