超声剪切波弹性成像联合miR-421对肉芽肿性乳腺炎、非肿块型乳腺癌的鉴别价值

Differentiation of Granulomatous Mastitis and Non-Mass Breast Cancer Using Shear Wave Elastography Combined with miR-421

目的:探讨超声剪切波弹性成像(SWE)联合微小RNA-421(miR-421)在肉芽肿性乳腺炎(GM)与非肿块型乳腺癌(NMBC)鉴别诊断中的应用价值。方法:回顾性分析抚州市第一人民医院2022年1月—2024年1月收治的118例NMBC及GM患者的临床资料。根据病理结果,将患者分为GM组(69例)与NMBC组(49例),比较两组SWE测量值、miR-421、糖类抗原125(CA125)、糖类抗原199(CA199)、骨桥蛋白(OPN)水平的差异,使用受试者操作特征(ROC)曲线评估SWE、miR-421及两者联合应用对NMBC的诊断效能。结果:NMBC组患者SWE测量值均显著高于GM组(P<0.05)。NMBC组患者miR-421、OPN、CA125及CA199水平均显著高于GM组(P<0.05)。根据患者的诊断结果,将患者各项检测指标水平均作为自变量纳入logistic多因素回归分析中,结果表明,Emean、Eratio、miR-421、OPN、CA125和CA199均是NMBC的重要影响因素(P<0.05)。采用ROC曲线对Emean、Eratio、miR-421的诊断效能进行评估和比较,结果表明,各项指标联合检测的曲线下面积可达到0.989,敏感度98.0%,特异度97.1%。结论:超声SWE联合血液miR-421水平检测,可作为一种有效手段,对GM与NMBC进行鉴别诊断。此组合方法具有较高的灵敏度和特异性,有助于提高诊断准确率,为临床治疗提供更为精确的依据。

Objective:To explore the diagnostic value of shear wave elastography(SWE)combined with microRNA-421(miR-421)in differentiating between granulomatous mastitis(GM)and non-mass breast cancer(NMBC).Method:The clinical data of 118 patients with NMBC and GM,treated at the First People's Hospital of Fuzhou from January 2022 to January 2024 was analyzed.Based on pathological results,patients were divided into the GM group(69 patients)and the NMBC group(49 patients).Differences in SWE measurements,miR-421,carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),and osteopontin(OPN)levels were compared between the two groups.The diagnostic efficacy of SWE,miR-421,and their combined application for NMBC was assessed using receiver operating characteristic(ROC)curves.Result:SWE measurements in the NMBC group were significantly higher than those in the GM group(P<0.05).Similarly,levels of miR-421,OPN,CA125,and CA199 were significantly higher in the NMBC group(P<0.05).According to the diagnostic results of patients,the levels of each detection index of patients were included as independent variables in logistic multivariate regression analysis.The results showed that Emean,Eratio,miR-421,OPN,CA125 and CA199 were important influencing factors for NMBC(P<0.05).ROC curve was used to evaluate and compare the diagnostic efficacy of Emean,Eratio and miR-421.The results showed that the area under the curve of the combined detection of each index could reach 0.989,the sensitivity was 98.0%,and the specificity was 97.1%.Conclusion:The combination of SWE and blood miR-421 level measurement is an effective method for differentiating between GM and NMBC.This combined approach provides high sensitivity and specificity,improving diagnostic accuracy and offering a more precise basis for clinical treatment.