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| 女性良性乳腺结节增长的影响因素研究 | |
| 引用本文： | 樊娜,高鹰,魏玮,李书,陶凤然,蒋云雯,张卿. 女性良性乳腺结节增长的影响因素研究[J]. 中国全科医学, 2021, 24(30): 3799-3805. DOI: 10.12114/j.issn.1007-9572.2021.02.003 |
| 作者姓名： | 樊娜 高鹰 魏玮 李书 陶凤然 蒋云雯 张卿 |
| 作者单位： | 1.300070天津市,天津医科大学公共卫生学院 2.300052天津市,天津医科大学总医院健康管理中心 *通信作者：张卿,主任医师;E-mail：zhangqing@tmu.edu.cn 注：樊娜、高鹰共同为第一作者 |
| 基金项目： | 国家自然科学基金资助项目（71804124,71704130,71904142） |
| 摘 要： | 背景 近年来良性乳腺结节的发病率不断升高,但目前关于超声测量良性乳腺结节（BI-RADS分级2级或3级）生长的影响因素研究较为缺乏。目的 探究女性良性乳腺结节增长的影响因素。方法 选取2013年1月至2019年1月在天津医科大学总医院健康管理中心接受年度乳腺超声筛查并首次检出良性乳腺结节的1 399例女性为研究对象。收集患者的基线信息、血脂、血糖、肿瘤标志物、血常规,分析基线和随访期间良性乳腺结节的位置、数量、大小、回声、成分、边缘、形态、钙化、血流、导管扩张情况、对侧乳腺有无结节等超声成像特征。研究截止时间为随访测量结节有增长的时间或随访截止时间（2019年12月）。采用多因素Cox比例风险回归模型分析良性乳腺结节增长的影响因素。结果 1 399例女性患者平均年龄为（45.7±9.3）岁,中位随访时间为1.08年。截至研究截止时间,654例（46.7%）患者超声测量良性乳腺结节直径有增加。多因素Cox比例风险回归模型分析结果显示,年龄<50岁〔HR=1.25,95%CI（1.05,1.50）〕、血小板计数>252×109/L〔HR=1.19,95%CI（1.01,1.40）〕、结节最大径<8 mm〔HR=1.62,95%CI（1.35,1.95）〕及多发结节〔HR=1.23,95%CI（1.03,1.47）〕为良性乳腺结节增长的独立危险因素（P<0.05）。结论 在良性乳腺结节患者中,年轻女性伴有血小板计数升高、初次超声测量乳腺结节最大径较小及为多发结节时,乳腺结节增长的风险较高。因此,临床应重视对存在上述特征的女性进行乳腺结节监测,并缩短随访间期,以实现结节的及时控制和有效管理。 |
| 关 键 词： | 乳腺疾病 女性 超声检查,乳房 乳腺囊肿 生长 影响因素分析, |
Influencing Factors of Benign Breast Nodules Growth in Women |
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| FAN Na,GAO Ying,WEI Wei,LI Shu,TAO Fengran,JIANG Yunwen,ZHANG Qing. Influencing Factors of Benign Breast Nodules Growth in Women[J]. Chinese General Practice, 2021, 24(30): 3799-3805. DOI: 10.12114/j.issn.1007-9572.2021.02.003 | |
| Authors: | FAN Na GAO Ying WEI Wei LI Shu TAO Fengran JIANG Yunwen ZHANG Qing |
| Affiliation: | 1.School of Public Health,Tianjin Medical University,Tianjin 300070,China 2.Healthy Management Center,Tianjin Medical University General Hospital,Tianjin 300052,China *Corresponding author：ZHANG Qing,Chief physician;E-mail：zhangqing@tmu.edu.cn FAN Na and GAO Ying are the co-first authors |
| Abstract: | Background The incidence of benign breast nodules is increasing in recent years,but studies about the factors affecting the growth of benign breast nodules measured by ultrasound（BI-RADS 2 or 3） are very limited. Objective To identify factors associated with the growth of benign breast nodules. Methods A total of 1 399 women with newly detected benign breast nodules by annual ultrasound screening for breast were selected from Health Management Center of Tianjin Medical University General Hospital between January 2013 and January 2019. Basic demographics,blood lipids,blood glucose,tumor markers and routine blood parameters were analyzed. Ultrasonic imaging characteristics such as the location,number,size,echo,composition,margin,morphology,calcification,blood flow,ductal dilatation,and presence of nodules in the contralateral breast were analyzed at baseline and during follow-up. Multivariate Cox proportional hazards model was used to identify the factors associated with the growth of benign breast nodules. Results The mean age of the participants was （45.7±9.3）years,and the median follow-up time was 1.08 years. Up to the study's completion time,654 cases （46.7%） showed an increase in the diameter of the nodules measured by ultrasound. Multivariate Cox proportional hazards regression analysis results revealed that,age <50 years old 〔HR=1.25,95%CI（1.05,1.50）〕,platelet count >252×109/L 〔HR=1.19,95%CI（1.01,1.40）〕,maximum diameter of nodules <8 mm 〔HR=1.62,95%CI（1.35,1.95）〕,and multiple nodules〔HR=1.23,95%CI（1.03,1.47）〕 were all independent risk factors for the growth of benign breast nodules. Conclusion Increased risk of growth of benign breast nodules in women was independently associated with younger age,elevated platelet count,smaller maximum diameter of breast nodules initially measured by ultrasound,and prevalence of multiple nodules. Therefore,clinical priority should be given to the monitoring of breast nodules and shorten the follow-up interval in female individuals with one of the above-mentioned risk factors,to achieve timely control and effective management of nodules. |
| Keywords: | Breast diseases Femininity Ultrasonography,mammary Breast cyst Growth Root cause analysis, |
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