常规筛查经验对临床超声诊断乳腺癌影响的分析

目的：探讨乳腺癌早期诊断中物理检查结合超声诊断结果的临床价值。方法对湖北省恩施市中心医院体检乳腺异常病例8000例，结合其乳腺超声检查结果与乳腺物理检查中的异常表现进行诊断分析。结果望诊异常患者中确诊乳腺癌患者9例，与望诊无异常患者比较其差异具有统计学意义（χ2＝11．367，P＜0．05）。触诊异常组乳腺癌患者9例（27．3％），显著高于触诊正常组（χ2＝11．200，P＜0．05）。乳腺超声检查的病灶漏报率为19．3％。乳腺查体联合超声对乳腺癌诊断的准确率显著高于单独望诊、触诊、望诊与触诊结合（χ2值分别为18．546、9．872、8．633，均P＜0．05）。结论常规望诊和触诊结合超声诊断对乳腺癌早期诊断具有重要的临床价值。

Impact of physical examination on early diagnosis of breast cancer by ultrasound

Objective To evaluate the clinical value of physical examination combined with ultrasonic diagnosis in early diagnosis of breast cancer.Methods Totally 8 000 cases with abnormality in breast checked in Centre Hospital of Enshi City in Hubei Province were diagnosed by combining ultrasound examination results and abnormalities in physical examination.Results Among the suspected cases by inspection, 9 cases were confirmed with breast cancer, which was significantly more than the cases with breast cancer in normal group by inspection （χ2 =11.367, P〈0.05）.There were 9 cases （27.3%） of breast cancer suspected by palpation, and the proportion was significantly higher than that in normal group by palpation （χ2 =11.200, P〈0.05）.The rate of missing report by ultrasonography was 19.3%.The diagnostic accuracy of breast cancer by physical examination combined with ultrasonography was significantly higher than that of inspection alone, palpation alone, or inspection combined with palpation （χ2 value was 18.546, 9.872 and 8.633, respectively, all P〈0.05）. Conclusion Routine inspection and palpation in combination with ultrasound diagnosis is of great value for early diagnosis of breast cancer.