乳腺癌钼靶摄影X线征象分析

目的探讨乳腺X线摄影对乳腺癌的诊断价值及X线征象,以提高乳腺癌诊断水平。方法对我院99例经手术或穿刺病理证实为乳腺癌患者的钼靶 X线征象进行回顾性分析。结果99例乳腺癌患者X线征象：直接见到肿块90例,毛刺征43例,钙化39例,未见明确肿块9例。结论钼靶X线摄影在乳腺癌诊断中具有较高的应用价值。     

高频彩色多普勒超声及钼靶X线检查对早期乳腺癌的诊断价值

目的：评价高频彩色多普勒超声及钼靶X线检查对早期乳腺癌的诊断价值。方法回顾分析经手术病理证实的106例早期乳腺癌患者资料,术前均经高频彩色多普勒超声及钼靶X线检查,对单独使用和联合使用2种检查方法对早期乳腺癌的诊断准确率进行统计分析。结果高频彩色多普勒超声与钼靶X线检查对早期乳腺癌的诊断准确率差异无统计学意义（P〉0.05）;高频彩色多普勒超声、钼靶X线检查对早期乳腺癌的诊断准确率均低于2种方法联合应用,差异均有统计学意义（P值均〈0.05）。结论高频彩色多普勒超声与钼靶X线均为筛查和诊断早期乳腺癌的主要手段,两者联合应用可提高早期乳腺癌的诊断率。     

螺旋CT结合钼靶X线在乳腺癌早期诊断中的应用

目的 分析螺旋CT结合钼靶X线在乳腺癌早期诊断中的应用价值。方法 选取2017年4月~2018年4月至我院就诊的乳腺癌患者80例,均接受螺旋CT检查与钼靶X线检查,以病理检查为标准,比较两种检查方法单独检查及联合检查的准确率。结果 钼靶X线检测阳性率及CT检查阳性率均较病理检查阳性率低,差异有统计学意义（P＜0.05）;钼靶X线联合CT检查阳性率与病理检查阳性比较,差异无统计学意义（P＞0.05）;单独采用螺旋CT、钼靶X线与二者联合诊断检测乳腺癌的特异度比较,差异无统计学意义（P＞0.05）;钼靶X线的检测准确率低于联合诊断 （P＜0.05）,而螺旋CT与联合诊断的检测准确率比较,差异无统计学意义（P＞0.05）;联合诊断的灵敏度为96.00%,高于单独使用钼靶X线的84.00%及螺旋CT 的85.33%,差异有统计学意义（P＜0.05）。结论 螺旋CT与钼靶X线二者联合应用相较于二者单项诊断,其在准确率、灵敏度上具有一定优势,可以作为临床乳腺癌早期诊断的可靠手段。     

钼靶X线联合高频彩超在乳腺癌早期筛查中的应用价值

目的 探讨钼靶X线联合高频彩超在乳腺癌早期筛查中的应用价值。方法 选取2016年1月~2018年12月于什邡市人民医院就诊的126例早期乳腺癌患者（直径＜2 cm）作为研究对象。所有患者均被序贯予以钼靶X线和高频彩超检查,比较钼靶X线、高频彩超及联合检测早期乳腺癌筛查的血流信号检出率、微钙化灶检出率及诊断准确率。结果 高频彩超血流信号检出率为80.16%,高于钼靶X线的21.43%;高频彩超微细钙化检出率为33.33%,低于钼靶X线的59.52%,差异有统计学意义(P＜0.05)。高频超声诊断准确率为82.54%,高于钼靶X线的80.16%,差异无统计学意义(P＞0.05);而联合检查诊断准确率为96.83%,高于单用高频超声和单用钼靶X线,差异有统计学意义(P＜0.05)。结论 钼靶X线、高频彩超应用于乳腺癌的早期筛查各有优劣,联合应用能提高诊断乳腺癌的准确率,具有较高的临床价值。     

钼靶X射线摄片与血清CA15-3、CEA和OPN联检对乳腺癌的临床诊断价值

目的:探讨乳腺钼靶X射线摄片与血清CA15-3、CEA和OPN联检对乳腺癌的临床诊断价值。方法:对36例经手术和病理证实的乳腺癌患者的血清CA15-3、CEA、OPN检测结果和乳腺钼靶X射线征象作回顾性统计分析。结果:乳腺癌患者血清CA15-3、CEA、OPN水平均非常显著地高于正常人组(P<0.01),血清CA15-3、CEA、OPN和钼靶X射线摄片联检的敏感性较单独检查有显著提高(P<0.01)。结论:对乳腺癌患者进行血清CA15-3、CEA、OPN联检和钼靶X射线摄片检查可提高其阳性检出率。对早期诊断、治疗和监视、随访有重要的临床价值。     

血清肿瘤标志物和乳腺钼靶在乳腺癌诊断中的应用价值

目的 探讨乳腺钼靶和血清肿瘤标志物在乳腺癌诊断中的应用价值.方法 回顾性分析2013年1月至2014年10月在我院明确诊断的104例乳腺癌患者的临床资料,按照乳腺肿块大小分别统计乳腺钼靶和血清肿瘤标志物CEA、CA153和CA125检测结果,对两种检查方法阳性符合率进行比较,探讨其在乳腺癌诊断中的意义.结果 乳腺肿瘤直径＜2cm组、2～ 5cm组、＞5cm组,钼靶结果阳性率分别为76.7％,87.5％,94.4％;肿瘤标志物联合诊断阳性率分别为33.3％,62.2％,100％.结论 在乳腺癌诊断中,钼靶诊断是乳腺癌诊断的重要方法,其诊断阳性率明显高于血清肿瘤标志物诊断;血清肿瘤标志物在晚期肿瘤中阳性率明显高于早期肿瘤,其在癌症复发监测、肿瘤疗效评价中的有较高价值.     

高频超声、钼靶X射线在乳腺BI-RADSⅣ～Ⅴ级诊断中的应用对比研究

目的 探讨高频超声、钼靶X射线单独与联合应用在乳腺影像报告与数据系统(BI - RADS)Ⅳ～Ⅴ级诊断中的应用价值及对比研究.方法 136个病灶经病理证实为乳腺恶性肿瘤,回顾性分析高频超声、钼靶X射线影像表现,并对诊断的准确性进行统计学分析.结果 高频超声、钼靶X射线及两者联合应用对乳腺BI- RADSⅣ-Ⅴ级诊断的正确率、误诊率比较,差异有统计学意义,P＜0.01.结论 高频超声在乳腺肿块(BI - RADS Ⅳ～Ⅴ级)诊断正确率方面优于钼靶X射线,特别是肿瘤直径＜1.0cm,且不伴有钙化时,两者联合应用较单一方法更能提高乳腺肿块(BI - RADS Ⅳ～Ⅴ级)的检出率及良、恶性鉴别诊断.     

钼靶X射线摄片与血清CEA、CA19-9、CA15-3联合检查对乳腺癌的临床诊断价值

为探讨乳腺钼靶X射线摄片与血清CEA、CA19-9、CA15-3联合检查对乳腺癌的临床诊断价值,对87例经手术及病理证实的乳腺疾病患者的CEA、CA19-9、CA15-3检测结果和乳腺钼靶X射线征象作回顾性统计分析。结果显示：乳腺癌组的三项血清学指标远远大于良性病变组和正常对照组（P〈0.01）,与良性病变组比较,t值分别为3.2903、3.8996、4.5236,P均〈0.01;与正常对照组比较,t值分别为4.3428、5.0101、5.9098,P均〈0.01。乳腺良性病变组与正常对照组比较,t值分别为1.6378、0.6346、1.2225,P均〈0.05。CEA、CA19-9、CA15-3、钼靶X射线摄片四项联合检查的敏感性较单独检测有明显提高（P〈0.01）,乳腺癌组单项检查与四项联合检查比较,χ2值分别为55.008、47.868、24.901、13.818,P〈0.01。结论：对乳腺癌患者CEA、CA19-9、CA15-3进行联合检测和钼靶X射线摄片检查可以提高其检出率,对于早期诊断、治疗和监视、随访有临床意义。     

超声和钼靶X线联合诊断2cm以内乳腺癌的临床价值

目的：评价超声和钼靶X线联合在2cm以内乳腺癌诊断中的临床价值。方法选取疑似乳腺小肿块患者78例并展开彩超和X线钼钯检查,并将两种检查诊断结果与病理结果进行对比。结果彩超检查、X线钼钯检查以及两种检查手段联合的诊断符合率分别为69.23%、66.67%、92.31%,联合检查诊断符合率较单独应用显著升高(P<0.05)。结论采取超声和钼钯X线联合检查对2cm以内乳腺癌的诊断价值显著,值得推广。     

乳腺钼靶X线影像中结构扭曲检测技术研究的进展

乳腺癌是全球女性发病率最高的恶性肿瘤,通过筛查实现早期发现、早期诊断和早期治疗对降低乳腺癌死亡率至关重要。乳腺钼靶X线摄影术是目前最普遍适用的乳腺癌筛查方法。有效检测乳腺钼靶X线影像中的结构扭曲病灶有利于提高筛查的质量和效率。就目前乳腺钼靶X线影像中结构扭曲检测技术的研究现状、存在的问题和发展趋势进行了综述。     

Diagnostic and prognostic potential of serum angiopoietin-2 expression in human breast cancer

Background: Accumulating evidence demonstrated a link of increased expression of Angiopoietin-2 (Ang-2) with invasive and metastatic phenotypes of various types of human cancers. However, until now, the serum level and its diagnostic and prognostic potential in breast cancer have not been investigated. Methods: Enzyme-linked immunosorbent assays were used to measure the levels of Ang-2. Sensitivity, specificity and area under curve (AUC) for serum Ang-2 levels were determined using receiver operator characteristic (ROC) analysis. Survival curves were plotted using the Kaplan-Meier method and differences in survival rates were analyzed using the log-rank test. Prognostic relevance of each variable to overall survival (OS) and disease-free survival (DFS) were analyzed using the Cox regression model. Results: Serum expression of Ang-2 in patients with breast cancer was significantly higher than healthy control group (3171 ± 1024 vs. 1800 ± 874 pg/ml, P < 0.0001). ROC curve analysis showed that at the optimal cut-off (2558.5 pg/ml), serum level of Ang-2 had a sensitivity of 78.3% and a specificity of 77.0% for distinguishing breast cancer patients from healthy controls with an area under the curve (AUC) of 0.836 (P < 0.001, 95% confidence interval: 0.787-0.885). The 5-year OS of high Ang-2 expression group was significantly shorter than that of low Ang-2 expression group (55.9% vs. 80.3%; P = 0.018). Moreover, the 5-year DFS of high Ang-2 expression group was also significantly shorter than that of low Ang-2 expression group (46.0% vs. 68.7%; P = 0.029). Conclusions: Our data indicate that serum Ang-2 level has potential value for early detection of breast cancer. Furthermore, Ang-2 has prognostic value in patients with breast cancer.     

游离PSA/总PSA比值在乳腺癌诊断中的临床价值

目的 探讨血清游离前列腺特异抗原(f-PSA)／总前列腺特异抗原(t-PSA)比值对乳腺癌的诊断价值。方法 用放射免疫法检测26例乳腺癌、67例乳腺增生和20例正常对照组的血清f-PSA、t-PSA，并计算f-PSA/t-PSA比值，评价其对乳腺癌的诊断价值。结果 以f-PSA/t-PSA为0．15为判断上限时，其诊断敏感性为90．9％，特异性为87．5％，诊断准确性为88．6％，明显优于t-PSA和f-PSA单测结果。结论 f-PSA/t-PSA比值有助于乳腺癌的诊断。     

CR乳腺摄影与病理对照对小乳腺癌的诊断的价值

目的评价CR乳腺摄影与病理对照对小乳腺癌定性诊断的价值,提高乳腺癌、特别是早期乳腺癌术前诊断水平。方法对51例乳腺癌的病人实施CR乳腺摄影,乳腺片有两名以上的医师用工作站结合CR片读片分析,术后照CR乳腺标本与原CR片对照,再与术后病理结果对照。结果CR乳腺摄影的敏感性、特异性、准确性分别为96.1%、98%、94.1%。结论CR乳腺摄影有很高的定性价值,可以显示小乳腺癌的直接征像和间接征象,明显优于传统钼靶片,值得临床推广应用。     

超声造影增强模式在乳腺良恶性肿块鉴别诊断中的价值

目的探讨超声造影增强模式对乳腺良恶性肿块鉴别诊断的价值。方法选择40例经病理组织检查证实的乳腺肿瘤患者,均为女性,年龄25～54岁,平均年龄35岁。其中良性肿块25例,恶性肿块15例。使用Siemens Sequoia 512彩色多普勒超声诊断仪,造影剂采用SonoVue,行超声造影增强方式检查。结果乳腺良恶性肿块超声增强方式不同,良性肿块以整体不同程度地均匀型增强改变为主(80%,20/25),恶性肿块主要表现为不均匀增强或周边增强(86.7%,13/15)。结论乳腺良恶性肿块超声造影增强模式不同,可为鉴别诊断提供帮助。     

B超与X线对中国人乳腺癌诊断价值的对照研究

目的 比较X线摄影、B超及两者联合应用对中国人乳腺癌的诊断价值,为临床选择检查方法提供参考。方法 根据体检结果,把473例经病理证实的乳腺占位病人分为可触及肿块与未触及肿块两组,采用诊断性试验的方法分别比较两组中X线摄影、B超及两者联合应用(串联、并联)的诊断准确率。结果 可触及肿物组,灵敏度:并联>B超>X线>串联;特异度:串联>B超>X线>并联。未触及肿物组,灵敏度:并联>X线>B超>串联;特异度:串联>B超>X线,并联。B超、X线乳腺摄影及联合应用的灵敏度与特异度亦无明显差异,结果与病检高度一致。结论 B超应作为中国人乳腺癌诊断的首选检查,联合应用X线检查不能提高诊断效率。     

Comparison of fine-needle aspiration cytology and core biopsy for diagnosis of breast cancer

Both fine-needle aspiration (FNA) cytology and core biopsy are useful in the diagnosis of breast cancer. In order to compare the sensitivities of these procedures, we reviewed 209 patients with breast cancer who had either FNA, core biopsy, or both, and also either mastectomy or lumpectomy. Sensitivities for FNA and core biopsies for diagnosing breast cancer were calculated and compared. Sensitivity for FNA or core biopsies interpreted as either atypical or malignant was 93.8% for FNA and 90.1% for core biopsy (P > 0.05). Sensitivity for FNA or core biopsies interpreted as malignant was 65.4% for FNA and 88.7% for core biopsy (P < 0.0001). Sensitivities of FNA interpreted as either atypical or malignant were 92.4% for FNA performed by pathologists and 100% for FNA by nonpathologists (P > 0.05). Sensitivities of FNA interpreted as malignant were 75.8% for FNA by pathologists and 20.0% for FNA by nonpathologists (P < 0.00001). Both FNA and core biopsies are sensitive procedures for the detection of breast cancer. There was no significant difference between sensitivity of FNA and core biopsies interpreted as either atypia or malignancy, although the sensitivity of core biopsies interpreted as unequivocal malignancy was greater than that of FNA. FNAs performed by pathologists were more sensitive than FNAs performed by nonpathologists in making an unequivocal diagnosis of breast cancer.     

肿瘤标志物在乳腺癌诊断及预后中的应用

肿瘤标志物已广泛应用于乳腺癌的诊断及预后.本综述总结了肿瘤抗原15-3 (CA15-3)、人表皮生长因子受体2( HER2)、雌激素受体(ER)及黄体酮受体(PR)等经典乳腺癌标志物的临床应用现状及新兴乳腺癌生物标志的临床价值.多标志物的联合检测较单一标志物有更高的灵敏度及特异性,将成为今后乳腺癌标志物的临床应用趋势.     

瘦素受体在早期乳腺癌中的预后判定价值

目的研究早期乳腺癌中,瘦素受体与临床病理指标的相关性及其预后判定价值。方法通过检索Pub Med、Embase及Cochrane临床试验注册数据库,筛选瘦素受体与乳腺癌预后相关研究。依据所纳入研究异质性强弱,用随机效应模型或固定效应模型进行荟萃分析。通过漏斗图及Egger检验判断有无发表偏倚。结果总计7项研究共1 990名患者纳入荟萃分析。瘦素受体表达水平与患者绝经状态、体质指数、肿瘤T分期、激素受体状态、Her2状态、腋窝淋巴结转移、P53及瘦素表达水平均无显著相关性。瘦素受体不同表达水平对无病生存期及总生存期均无显著影响。在文献免疫组化检测的亚组中,异质性显著降低,并提示免疫组化瘦素受体阳性患者,无病生存期显著延长(HR 0.63,95%CI 0.40~0.99,P0.05)。结论瘦素受体阳性早期乳腺癌患者,其复发风险显著减低。     

Diagnostic value of microRNA for pancreatic cancer: a meta-analysis

Introduction

MicroRNAs have been reported to be aberrantly expressed in patients with pancreatic cancer. The aim of the present meta-analysis is to establish the overall diagnostic accuracy of the measurement of microRNA for diagnosing pancreatic cancer.

Material and methods

After a systematic review of English language studies from Medline, Embase, and Cochrane Library, the sensitivity, specificity, and other measures of accuracy of microRNA in the diagnosis of pancreatic cancer were pooled using random-effects models. The methodological quality of each study was assessed by QUADAS (quality assessment for studies of diagnostic accuracy). Statistical analysis was performed by employing Meta-Disc 1.4 software and STATA. Summary receiver operating characteristic curves were used to summarize overall test performance. Deeks’ test was used to test the potential publication bias.

Results

Nine studies from seven publications met our inclusion criteria. The summary estimates for microRNAs in the diagnosis of pancreatic cancer in these studies were pooled sensitivity 0.89 (95% CI: 0.86-0.91), specificity 0.93 (95% CI: 0.90-0.95), positive likelihood ratio 11.62 (95% CI: 5.75-23.50), negative likelihood ratio 0.14 (95% CI: 0.08-0.24), diagnostic odds ratio 115.13 (95% CI: 33.73-351.28), and the area under the curve was 0.97.

Conclusions

MicroRNA assay plays an important role in the diagnosis of pancreatic cancer. The results of microRNA assays should be interpreted in parallel with clinical findings and the results of conventional tests.