BI-RADS 3级对乳腺病灶患者的诊断结果及影响因素分析

Diagnostic Results and Influencing Factors of 168 Patients with Ultrasound BI-RADS Grade 3 Breast Lesions

目的:回顾性分析超声BI-RADS 3级对乳腺病灶患者的诊断结果及影响因素。方法:选择2014年8月至2017年8月上海交通大学医学院附属第九人民医院和复旦大学附属华山医院北院收治的168例乳腺病灶患者,回顾性分析其影像学资料及病理分析结果。分析BI-RADS 3级对乳腺病灶的阴性诊断率,采用Kim分级对BI-RADS 3级结果进行重新分级,分析影响BI-RADS分级及重新分级的主要因素。结果:168例BI-RADS 3级乳腺病灶中,159例为良性病变,9例为恶性。168例BI-RADS 3级乳腺病灶的阳性预测值为5.4%(9/168),阴性预测值为94.6%(159/168)。病灶数目、年龄、医师年资、病灶大小对BI-RADS 3级良恶性乳腺病灶判断无明显影响,而BI-RADS 3级恶性乳腺病灶较良性病灶更易触诊(P <0.05)。重新分级发现,124例仍为BI-RADS 3级,44例上升至BI-RADS 4级,重新分级恶性病灶的检出率为100%(9/9),假阳性率为20.8%(35/168)。病灶多发、年龄≥40岁更可能评估为BI-RADS 4级(P<0.05),医师年资、病灶大小、病灶触及情况对重新分级无明显影响(P>0.05)。结论:BI-RADS 3级对乳腺良性病灶有较高的阴性诊断率,重新分级可提高乳腺恶性病灶的检出率,但会造成较高的假阳性率,影响BI-RADS分级的主要因素为病灶可否扪及,影响重新分级的主要因素为患者年龄及乳腺病灶是否多发。

Objective:To investigate the diagnostic results and influencing factors of 168 patients with ultrasound BI-RADS grade3 breast lesions.Methods:168 cases with breast lesion from Aug.2014 to Aug.2017 in Ninth Peoples Hospital Affiliated to Shanghai JiaoTong University School of Medicine and Northern District of Huashan Hospital Affiliated to Fudan University were chosen,the imaging data and pathological results were retrospective analyzed.The negative diagnosis rate of BI-RADS 3 breast lesion was analyzed,the BI-RADS grade 3 results were reclassification by Kim grade.The main factor influence of BI-RADS grade and reclassification were analyzed.Results:159 cases were benign and 9 cases were malignant in 168 cases of BI-RADS 3 grade breast lesions.The positive diagnosis rate of 168 cases with BI-RADS 3 breast lesions was 5.4%(9/168),the negative diagnosis rate of 168 cases with BI-RADS 3 breast lesions was 94.6%(159/168),the stoves numbers,age,doctor,sage,lesion size had no significant effect on the judgment of benign and malignant breast lesions in BI-RADS grade 3 breast lesions,the malignant breast lesions was more palpable than benign lesions in BI-RADS grade 3 breast lesions,P<0.05.124 cases were still BI-RADS grade 3 and 44 cases were BI-RADS grade 4 by reclassification.The malignant lesions rate of reclassification was 100%(9/9),the false positive rate was 20.8%(35/168).Multiple lesions,age≥40 years were more evaluated to BI-RADS grade 4(P<0.05),physician’s seniority,lesion size,and lesion exposure have no significant effect on reclassification(P>0.05).Conclusion:BI-RA DS 3 grade had high negative diagnosis rate for benign breast lesions,reclassification could increase the detection rate of malignant breast lesions,while which would improve the false positive rate.Whether the lesions could be affected or not was the main factor affecting the BI-RADS classification,the patients age and whether the breast lesions frequent or not were main factors affecting the re-grading.