高频超声与X线钼靶对早期乳腺癌的诊断价值

目的 分析比较高频超声、X线钼靶单独及两者联合应用对早期乳腺癌的诊断价值.方法 体检发现乳腺包块、怀疑乳腺肿瘤的258例患者,行高频超声、X线钼靶的单独检查和联合检查,并行手术治疗.对照分析手术病理与影像学表现.结果 258例患者,手术病理证实早期乳腺恶性肿瘤135例,良性乳腺肿瘤123例.对于诊断早期乳腺癌,联合检查的敏感性优于单独的高频超声检查或X线钼靶检查(P<0.05),准确性优于X线钼靶检查(P<0.05),特异性、阳性预测值、阴性预测值、假阳性、假阴性等指标3组间均无显著差异(P均>0.05).对于早期乳腺癌患者,高频超声和X线钼靶相比,检出的钙化灶较少(18.3% vs 36.5%,P<0.01),能够发现更多的乳腺癌腋窝淋巴结转移(69.0% vs 33.3%,P<0.01).结论 高频超声与X线钼靶的单独和联合检查对于早期乳腺恶性肿瘤均为可靠的影像学诊断方法,联合应用诊断早期乳腺癌具有较高的敏感性和准确性.

The diagnostic value of high frequency ultrasonography and molybdenum target imaging for early breast cancer

Objective To analyze and compare the independent and combined diagnostic values of high frequency ultrasonography (HFU) and molybdenum target imaging (MTI) for early breast tumor in a prospective study.Methods 258 patients with breast mass which were suspected as breast tumors by physical examination received HFU,MTI,their combined applications and operative treatments.Comparative studies were made between the surgical pathology and imaging evaluations.Results Totally 258 cases were enrolled in this study.Surgical pathology confirmed 135 cases of early breast cancer and 123 cases of benign breast tumor.For the diagnosis of early breast cancer,combined application was more effective than HFU or MTI alone in sensitivity (P<0.05),and more superior than MTI alone in accuracy.While the specificity,positive predictive value,negative predictive value, false positive rate, false negative rate had no difference among HFU, MTI and combined applications (P>0.05).In the patients of early breast cancer, compared with HFU,MTI found less nodules of calcification(18.3% vs 36.5%,P<0.01),but revealed more axillary lymph metastasis (69.0% vs 33.3%,P<0.01).Conclusion HFU and MTI alone or their combined application are reliable imaging methods for the diagnosis of early breast cancer.For the sensitivity and accuracy of diagnosis, combined applications has more superior advantages.