CT判断食管癌外侵程度与手术病理结果对比研究

目的探讨CT判断食管癌外侵程度与手术病理结果的一致性. 方法经手术病理证实的食管癌患者226例,与术前CT资料进行对比分析. 结果 CT判断食管癌外侵敏感性80.6%,特异性97.9%,阳性预测值86.2%,阴性预测值96.9%,准确性95.5%,假阴性 6例,假阳性 5例,食管壁厚度>2cm时肿瘤外侵率达92.0%. 结论 CT判断食管癌外侵基本可靠,对治疗方案的制订有价值,对手术的难度估计有帮助,术前CT检查是必要的.     

^18F—FDG SPECT／CT同种融合显像在肿瘤诊断中的应用

目的：初步评价FDG SPECT／CT符合线路同机图像融合在肿瘤诊断及复发监测中的应用价值。方法：经临床确诊的恶性肿瘤及恶性肿瘤治疗后怀疑复发或残留的患者53例（治疗前诊断8例、治疗后疑复发45例）。经SPECT／CT同机联合扫描行FDG显像检查，用二次迭代法加衰减校正进行影像重建，与同期CT或（和）MR检查相比较。结果：在治疗前诊断组中，8例恶性肿瘤患者FDG显像均呈阳性，CT（MR）亦全部发现病灶，但不能对病灶进行有效定性；在治疗（手术、放疗、化疗)后疑复发的45例患者中FDG与CT（MR）的假阳性、假阴性、真阳性、真阴性分别为0，4，32，9和3，7，29，6；FDG灵敏度、特异性、阳性预测值、阴性预测值分别为8．89％、100％、100％、69．2％；而CT或（和）MR分别为80．6％、66．7％、90．6％、46．2％。同机融合由CT提供的详细解剖资料能准确定位恶性病灶。结论：带有X线CT的符合线路的SPECT／CT同机融合PDG显像是一种新的有效的核医学显像方法，尤其是对治疗后残余或复发的肿瘤，较CT（MR）及其它功能性检查图像等更具有较特异的定性和准确性定位诊断价值，值得临床推广应用。     

磁共振胆胰管成像联合肿瘤标记物CA19—9在胆管癌诊断中的价值

目的：探讨磁共振胆胰管成像（MRCP）联合肿瘤标记物CA19－9在胆管癌中的诊断价值。方法：回顾性分析26例手术及病理主实为胆管癌和22例胆道良性疾病病人的术前MRCP影像特点，并结合血清肿瘤标记物CA19－9的检测进行评价。结果：MRCP诊断的敏感性为88％，特异性为84％，阳性预测值为85％，阳性似然比为5．5；CA19－9的敏感性为82％，特异性为79％，阳性预测值为84％，阳性似然比为3．9。联合诊断的敏感性为92％，特异性为88％，阳性预测值为96％，阳性似然比为7．7。结论：MRCP联合血清CA19－9的检测，提高了对胆管癌诊断的准确性。     

血浆1，3-β-D葡聚糖检测对儿童侵袭性真菌感染诊断价值

目的评价血浆1,3-β-D葡聚糖（BG）检测（G试验）对儿童侵袭性真菌感染（IFI）的诊断价值。方法回顾性分析2008年1月至2011年8月在首都医科大学附属北京儿童医院住院,抗生素应用时间〉10d,并行G试验患儿的临床资料,排除拟诊IFI者。根据IFI诊断标准,将研究对象分为IFI组和非IFI组。G试验测定采用GKT-5MSet动态真菌检测试剂盒,血浆BG浓度≥10pg·mL^-1判定G试验阳性。采用四格表计算G试验诊断IFI的敏感度、特异度、阳性预测值和阴性预测值。对G试验结果进行受试者特征工作曲线（ROC曲线）分析,并计算曲线下面积。结果研究期间共有525例患儿行G试验,排除拟诊IFI者129例,最终396例患儿纳入分析。IFI组43例,非IFI组353例。IFI组G试验阳性31／43例,阳性率为72．1％;阴性12／43例,假阴性率为27．9％。非IFI组G试验阳性48／353例,假阳性率为13．6％。G试验诊断IFI的敏感度、特异度、阳性预测值和阴性预测值分别为72．1％、86．4％、39．2％和96．2％。根据G试验结果绘制ROC曲线,曲线下面积为0．815（95％CI：0．732—0．898）。结论G试验对儿童IFI具有中等诊断价值。适当提高诊断界值或连续监测可很大程度消除假阳性。     

^99Tc^m-MIBI阳性显像诊断甲状腺癌的临床价值

目的 以临床病理学为基础，分析评价^99Tc^m-MIBI阳性显像诊断甲状腺癌的临床价值。方法 对105例甲状腺癌患者行早期和延迟甲状腺阳性显像，并对其影像学特征进行分析比较。结果 105例甲状腺癌中，^99Tc^m-MIBI阳性显像乳头状癌阳性有43例（82．7％），假阴性有9例（17．3％），灵敏度为82．7％；滤泡状癌阳性有37例（86．1％），假阴性有6例（14．0％），灵敏度为86．1％；其它类型阳性有5例（50．0％），假阴性有5例（50．0％），灵敏度为50．0％。其中乳头状癌组和滤泡状癌组灵敏度无明显差异（P〉0．05），但二者均高，于其它类型组（P〈0．05）。结论 ^99Tc^m-MIBI阳性显像对甲状腺癌诊断具有重要的临床价值。     

18F-FDG PET/CT对非小细胞肺癌淋巴结转移的诊断价值

目的探讨18氟-脱氧葡萄糖正电子发射计算机断层显像/计算机体层成像(18F-FDG PET/CT)对非小细胞肺癌淋巴结转移的诊断价值。方法回顾性分析2012年3月至2015年3月我院167例患者的临床资料,所有病例术前10 d内行18FFDG PET/CT及胸部增强CT检查并经术后病理诊断为非小细胞肺癌。根据PET/CT、增强CT及术后病理结果,计算PET/CT、增强CT判断淋巴结转移的灵敏度、特异性、准确度、阳性预测值、阴性预测值及约登指数并相互比较。结果 167例患者中共清扫出731组淋巴结,以术后病理结果为依据,PET/CT诊断出真阳性、假阳性、假阴性、真阴性淋巴结各有143组、26组、61组、501组,进而得出其灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数分别为70.10%、95.07%、88.10%、84.62%、89.15%、0.65,增强CT分别为54.19%、92.23%、81.67%、72.85%、83.97%、0.4,二者差异有统计学意义(P0.05)。结论 PET/CT对非小细胞肺癌淋巴结转移的诊断效能高于增强CT,可以更好地为肺癌术前诊断、分期和后续治疗方式的选择提供依据。     

SPECT/CT符合线路18F-FDG检查与同机CT融合在妇科肿瘤诊断中的作用分析

目的研究妇科肿瘤^18F-FDG符合线路SPECT／CT显像中同机CT融合的作用。方法27例各类妇科肿瘤术后患者共进行28次^18F—FDG符合线路SPECT／CT检查，将其结果与未经过同机CT融合的单纯^18F-FDG图像（AC）读图结果比较，并结合患者2周CT内诊断结果及随访检查进行分析。结果以病例分析，单纯^18F-FDG图像（AC）和CT融合对妇科肿瘤复发和转移的灵敏度、准确率和阳性预测值分别为91．7％、92．9％和100％，二者无统计学意义，但与CT的准确率和阳性预测值比较有统计学意义（P〈0．01）。以病灶分析，^18F-FDG符合线路SPECT／CT检查的灵敏度、准确率和阳性预测值分别为97．4％、97．7％和100％，单纯FDG图像（AC）的相应指标为97．4％、84．1％和86．0％。二者比较准确率和阳性预测值有统计学意义（P〈0．05）。单纯^18F-FDG图像（AC）显像共发现86个病灶，同机CT融合后减少为74个病灶，共11例次检查（39．3％）的单纯^18F-FDG图像（AC）在与同机CT图像融合后其读图结果发生改变，其中6例中的12个病灶因同机CT图像发现其为非恶性病灶摄取而确定为假阳性病灶予以排除。共8例患者（28．6％）的分期和治疗方案在SPECT／CT符合线路FDG检查后发生改变，其中2例患者（7．1％）的分期和诊断与同机CT融合前的单纯^18F-FDG图像（AC）结果不同。结论同机CT融合显著提高了^18F-FDG符合线路SPECT／CT显像对妇科肿瘤检查中病灶诊断的准确率和阳性预测值，并能进一步明确患者诊断、分期，提高^18F-FDG符合线路SPECT／CT显像对患者诊断分期和治疗的影响。     

99Tcm—MIBI亲肿瘤显像在乳腺癌诊断中的应用价值

目的 评价99Tcm锝-甲氧基异丁基异腈（99Tcm-MIBI）乳腺显像对乳腺癌诊断的价值。方法 对57例乳腺肿块患者经病变乳腺对侧肿静脉注射99Tcm-MIBI740～1110MBq后15min即行早期乳腺显像，分别采集正前位、左、右侧位像，采集计数1000k，1．5h后按上述条件作延迟显像。结果 57例乳腺肿块患者，99Tcm-MIBI核素显像阳性39例，阴性18例；41例乳腺癌患者99Tcm-MIBI核素显像阳性37例、阴性4例；16例良性病变中99Tcm MIBI核素显像阴性14例、阳性2例；99Tcm-MIBI核素显像诊断乳腺癌的灵敏度为90．2％，特异性87．5％。准确性为89．5％，阳性预测值94．9％．阴性预测值77．8％。结论 99Tcm-MIBI显像对乳腺肿块的患者能提供非常有价值的临床信息，对乳腺癌的诊断厦良、恶性病变的鉴别有较高的敏感性和准确性。     

对乳腺肿物针吸细胞学诊断标准的探讨——951例细胞学与组织学的对照分析

目的：探讨乳腺肿物针吸细胞学检查（FNAC）的基本形态学要素及拟定的诊断标准的可靠性与局限性。方法：对4309例患者行FNAC检查,其中951例获得组织病理学核对。结果：413例针吸涂片中,多数性质相同的病例显示具有相对一致的形态学变化特征。732例恶性肿瘤诊断的敏感性为97．3％,219例良性病变诊断的特异性为97．7％,总准确率为97．4％;假阴性率为2．7％,潜在假阳性率为2．3％,无1例假阳性,总误诊率为2．6％。结论：（1）导管上皮细胞分化、排列方式以及良性裸核细胞的数量是分析乳腺肿物FNAC形态学变的3个基本要素。（2）拟定的乳腺肿物FNAC诊断标准检查结果可靠性很强;但仍存在一定的局限性,需要通过病理组织学诊断解决。     

145例颞叶癫痫手术治疗及两年以上随访

目的：总结145例颞叶癫痫（TLE）的术前评估、手术方式和两年以上的随访结果。方法：对145例TLE患者的术前评估方法、手术方式、病理结果和手术效果进行了回顾性分析。结果：在145例TLE患者中,111例（76．6％）患者根据长程V—EEG和MRI等无创检查定位了致痫灶,34例（23．4％）需应用颅内电极记录定位。前颞叶切除或扩大前颞叶切除127例（87．6％）,合并颞叶以外切除16例（11％）;术后病理改变最常见的是海马硬化和皮质发育不良。随访（35．6±7．2）个月,Engel术后效果评估为Ⅰ级92例（63．4％,癫痂发作消失）,Ⅱ级25例（17．2％,癫痫发作极少或几乎消失）,Ⅲ～Ⅳ级26例（17．9％,癫痫发作频率减少〉50％）,Ⅴ级2例（1．4％,发作频率减少〈50％）。13例（8．9％）出现并发症,4例（2．7％）为永久性并发症。结论：按照标准的术前评估方法,当评估结果一致定位为一侧颞叶时,可直接行颞叶切除手术;当临床表现是不典型TLE、影像学阴性表现和术前需要准确定位语言区时,颅内埋藏电极和V—EEG长程监测是进行术前评估的必要手段。根据术中皮层脑电监测的结果和病理分析,前颞叶切除是TLE经典的有效的术式。     

Clinicopathological characteristics and prognosis of alpha-fetoprotein positive gastric cancer in Chinese patients

Purpose: This study aimed to review the clinicopathological, histochemical, and prognostic features of Alpha-Fetoprotein (AFP) positive gastric cancer. Patients and methods: Six hundred and fifty one patients with gastric cancer who underwent gastrectomy between January 2009 and December 2012 at The First Hospital of Jilin University were enrolled in the study. Among them, 45 patients were identified as AFP positive gastric cancer. The clinicopathologic characteristics and prognosis of the AFP positive gastric cancer patients were analyzed. Results: Among the 45 AFP positive patients, serum levels of AFP were < 100 µg/L in nine patients. The histological classification of 45 patients was as follows: hepatoid type, 25 (55.6%) cases; fetal gastrointestinal type, 12 (26.7%) cases; yolk sac tumor type, 2 (4.4%) cases; and mixed type, 6 (13.3%) cases. Twenty nine (64.4%) cases were AFP positive by immunohistochemical analysis; we found no significant difference in AFP positivity and histologic type. However, the differences in the number of metastasis lymph nodes, the maximum tumor diameter, pathological stage, vascular invasion and liver metastasis between the AFP positive group and the negative group were significant. At the same T stage, the liver metastasis status of the AFP positive group was higher than that of the negative group. The AFP positive group had a much poorer prognosis than the negative group. Conclusion: AFP positive gastric cancer is associated with aggressive behavior and poorer prognosis compared to that of AFP negative gastric cancer.     

p53基因突变与食管癌生物学行为的关系

目的为了探讨ｐ５３基因突变与食管癌生物学行为及预后的关系。方法应用ＰＣＲ－ＳＳＣＰ结合ＤＮＡ直接银染测序，对３０例散发性食管癌组织ｐ５３基因第５～８外显子进行检测。结果检出１１例阳性，突变检出率为３６．７％。９例为点突变，其中错义突变４例、无义突变２例、同义突变３例，其余２例为碱基插入和缺失导致的移码突变。统计学分析显示：中低分化食管癌的ｐ５３突变率为５６．３％，高分化组为１４．３％，两组相比有非常显著性差异（Ｐ＝０．０２５）；癌组织浸润累及食管壁全层的ｐ５３突变率５２．６％显著高于未累及全层组９．１％（Ｐ＝０．０２４）；有淋巴结转移组与无淋巴结转移组相比，ｐ５３突变率分别为６１．５％和１７．６％也具有非常显著性差异（Ｐ＝０．０２４）。结论ｐ５３基因突变与食管癌多种生物学行为如组织分化程度、肿瘤浸润程度及淋巴结转移有明显相关性。因此检测食管癌组织中是否存在ｐ５３基因突变有助于判断食管癌的恶性程度和患者的预后。还讨论了ｐ５３基因的“显性负效应”及同义突变的遗传学效应。     

早期宫颈癌淋巴脉管间隙浸润与其预后生存的关系研究

目的:探讨早期宫颈癌淋巴脉管间隙浸润与其预后生存的关系。方法:回顾性分析2013年5月至2016年5月本院收治的经实验室检查确诊为早期宫颈的84例患者的临床资料。整理患者术后病理检查结果,分析影响早期宫颈癌淋巴脉管间隙浸润对患者预后的影响。结果:经非条件单因素Logistic回归模型分析得出:组织学分型、分化程度、淋巴结转移、宫颈间质浸润深度为影响早期宫颈癌阳性淋巴脉管间隙浸润患者预后生存的单因素(P<0.05);经非条件多因素Logistic回归模型进一步分析,得出:低度分化、有淋巴结转移、宫颈间质浸润深度≧1/2为影响早期宫颈癌阳性淋巴脉管间隙浸润患者预后生存的危险因素(P<0.05);阳性、阴性淋巴脉管间隙浸润组患者4年内总生存率分别为77.50%、93.18%,4年无疾病进展生存率分别为67.50%、86.36%,相比存在统计学差异(P<0.05)。结论:淋巴脉管间隙浸润是影响早期宫颈癌患者预后生存的重要因素之一;低度分化、有淋巴结转移、宫颈间质浸润深度≧1/2为影响早期宫颈癌阳性淋巴脉管间隙浸润患者预后生存的危险因素。     

B7-H1 expression associates with tumor invasion and predicts patient’s survival in human esophageal cancer

B7-H1, an important member of the B7-CD28 super family, has been reported to play an important role in regulation of T-cell mediated anti-tumor response, and also has effect in the biological characteristics of the tumor cells themselves. The bulk of data indicate that cancer immunotherapy targeting the molecule B7-H1 recently has sparked growing interest. We have previously reported that higher expression of B7-H1 in human gastric cancer significantly associated with tumor size, invasion, nodal metastasis, survival and the density of infiltrating Foxp3+ Tregs. In the present study, we used tissue microarray to further study B7-H1 expression in human esophageal cancer tissues and its clinical significance. We found that positive membranous B7-H1 expression could be found in some human esophageal cancer cell lines, and both membranous/cytoplasm and nuclear staining of B7-H1 could be found in esophageal cancer tissues. We demonstrated that the membranous/cytoplasm B7-H1 expression in human esophageal cancer tissues was significantly correlated with tumor invasion depth (P = 0.0261), whereas it was not correlated with patient’s gender, age, tumor size, nodal metastasis, distant metastasis and TNM stage. The survival analysis showed that the overall survival of the patients with positive B7-H1 membrane/cytoplasm expression was significantly poorer than that of the patients with negative B7-H1 membrane/cytoplasm expression (Hazard ratio = 2.157, 95% CI: 1.017-4.577, P = 0.0452). Moreover, we also found that the nuclear B7-H1 expression in human esophageal cancer tissues was significantly correlated with tumor invasion depth (P = 0.0331), whereas it was not correlated with other parameters. The log-rank survival analysis showed that there was no statistically significant difference in prognosis between the patients with positive nuclear B7-H1 staining and the patients with negative nuclear B7-H1 staining (P = 0.6755). Thus, our data showed that B7-H1 can serve as a prognostic predictor for human esophageal cancer, and also could be an important therapeutic target for the immune therapy against this malignancy.     

Endobronchial Ultrasound Application for Diagnosis of Tracheobronchial Tree Invasion by Esophageal Cancer

INTRODUCTION:

Esophageal cancer staging has been performed through bronchoscopy, computerized tomography (CT), positron emission tomography (PET), and endoscopic ultrasound (EUS). Whereas CT and PET scan provide assessments of distant metastasis, bronchoscopy importantly diagnoses tracheobronchial involvement, complementing chest CT findings. EUS is the most accurate examination for T and N staging but is technically limited when tumoral stenoses cannot be traversed. Endobronchial ultrasound (EBUS) appears to present greater accuracy than EUS, CT, and bronchoscopy for assessing tracheobronchial wall involvement. EBUS has been recently associated with EUS for esophageal cancer staging in our unit.

OBJECTIVE:

To compare EBUS findings in esophageal cancer patients without evident signs of tracheobronchial invasion on conventional bronchoscopy with EUS and CT.

METHODS:

Fourteen patients with esophageal cancer underwent CT, conventional bronchoscopy, EUS, and EBUS for preoperative staging. All patients underwent EBUS and EUS with an Olympus® MH-908 echoendoscope at 7.5 MHz. Seven patients were eligible for the study according to the inclusion criteria.

RESULTS:

The echoendoscope could not traverse tumoral esophageal stenosis to perform EUS in two patients, and invasion was effectively diagnosed by EBUS. In 4 (57%) of 7 patients EBUS revealed additional information to staging. In the remaining 3 cases the invasion findings were the same under both EUS and EBUS.

CONCLUSION:

EBUS showed signs of tracheobronchial invasion not observed by conventional bronchoscopy, adding information to staging in most of the cases when compared with CT and EUS.     

Immunohistological analysis of thymoma by molecules differentially expressed in the thymic cortex and medulla, and its application in the differential diagnosis of thymoma from esophageal and lung cancer

The purpose of this study was to verify the WHO classification of thymic tumors using immunohistological methods, and to discover whether these methods can be applied to differentiate thymoma from squamous cell carcinoma (SCC) of the esophagus and the lung. Twenty-nine thymoma cases were classified according to WHO and were then immunohistologically examined for the positivity of these molecules. All thymoma cases investigated in this study were positive for IL-1R, and most of them were also positive for bek. In contrast, UH-1 was highly positive in B1 and B2 type thymomas, but negative or weakly positive in A, AB and B3 type thymomas. Twelve esophageal cancers and 21 lung cancers were also examined for the positivity of the same molecules. All esophageal cancers were negative for UH-1. Three of 12 cases were weakly positive for IL-1R, and four of these 12 cases were also weakly positive for bek. Twelve of 21 lung cancer cases were adenocarcinomas, all of them negative for IL-1R, bek and UH-1. Nine of 21 lung cancer cases were SCCs, all of them negative for UH-1. Eight of nine SCC cases were strongly positive for IL-1R, while seven of these were weakly positive for bek. We conclude that the WHO classification of thymic tumors is still valid as demonstrated by immunohistological analysis and that the positivity of UH-1, IL- 1R and bek might be helpful in differentiating thymoma from SCC of the esophagus and the lung.     

CEACAM1和CD34蛋白表达与胃癌侵袭转移的关系

目的探讨癌胚抗原相关黏附分子1(CEACAM1)和CD34蛋白表达与胃癌侵袭转移的关系。方法免疫组化SP法检测90例胃癌组织和30名正常胃黏膜组织中CEACAM1及CD34的表达情况,分析CEACAM1和CD34标记的微血管密度(MVD)与胃癌患者临床病理特征的关系。结果 CEACAM1和CD34蛋白在胃癌中的阳性表达明显高于正常胃黏膜组织(P0.05)。CEACAM1蛋白的表达程度与肿瘤分化、侵袭深度、是否淋巴结转移及病理分期相关(P0.05),胃癌组织中MVD与肿瘤大小、分化、侵袭深度、是否淋巴结转移及病理分期相关(P0.05)。CEACAM1表达程度及CD34标记的MVD在胃癌中的表达呈正相关关系(P0.05)。结论 CEACAM1与CD34参与了胃癌的侵袭和转移,有望成为胃癌发生、发展和预后的预测指标。     

食管癌及癌旁组织中端粒酶活性检测及其意义

目的探讨食管癌及癌旁组织中端粒酶活性检测的意义.方法采用PCR技术为基础的TRAP法检测了39例食管癌及癌旁组织端粒酶活性.结果39例食管癌组织中34例端粒酶活性阳性,阳性率为87.2%,癌旁组织中3例阳性,阳性率为7.7%,9例食管良性组织中1例阳性,阳性率为11.1%.食管癌与相应癌旁组织和良性食管组织端粒酶阳性检测率相比,差异有显著性意义(p<0.01).伴有淋巴结转移的25例食管癌端粒酶阳性检测率为96.0%,显著高于未伴有淋巴结转移的阳性率(71.4%),两者差异有显著性意义(p<0.05).结论端粒酶激活与食管癌发生发展有关,对端粒酶活性进行检测对食管癌的诊断和判断预后有重要价值.     

食管癌Ivor-Lewis和Sweet手术的解剖病理学评价

目的比较中段食管癌手术治疗术式的利弊,以提高食管癌的手术疗效。方法选择2010年1月至2012年6月位于食管中段的食管癌住院手术患者110例,依据术式不同,即经右胸Ivor-Lewis手术和左胸Sweet手术,将病例分为Ivor-Lewis组55例和Sweet组55例。对比分析2组术后切除标本的食管长度、肿瘤浸润和切除距离、切缘癌残留的发生率、胸腔和腹腔淋巴结清除的数量及癌浸润淋巴结的阳性率等,并以问卷调查的方式对医师参加Ivor-Lewis组和Sweet组术中处理胸部和腹部的解剖学问题进行评分比较。结果在食管切除长度、淋巴结清除个数方面Ivor-Lewis组明显大于Sweet组(P0.01);Ivor-Lewis组食管癌切缘癌残留阳性发生率为1.82%,显著低于Sweet组的21.82%(P0.01);问卷调查手术医师对2组术中解剖问题评分Ivor-Lewis组明显优于Sweet组。结论食管中上段癌外科手术建议采取Ivor-Lewis术式,贲门部及下段食管癌适宜Sweet手术。     

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。