超声诊断技术在乳腺癌早期诊断中的应用

目的 探讨超声诊断技术在乳腺癌早期诊断中的应用价值。方法 同期经手术和病理证实≤2cm的乳腺实性肿块患者1836例,分为3组,术后病理诊断为早期乳腺癌423例为A组,非早期乳腺癌145例为B组,良性肿块1268例为C组。比较3组病灶术前二维声像图及彩色多普勒血流图特征,结合钼靶乳腺X线检查、乳腺临床检查,并与针吸细胞学活体组织检查、手术和病理结果对照进行回顾性分析。结果 与乳腺良性肿块相比较,乳腺癌组病灶超声声像图具有以下7大超声声像图特征:形态不规则、边缘不规整、纵横比>1、后方声衰减、内部见微小钙化以及Ⅱ级以上彩色血流伴阻力指数(resistant index,RI)>0.70。早期乳腺癌和非早期乳腺癌的超声声像图特征比较差异无统计学意义(P>0.05)。在早期乳腺癌组,乳腺超声检查的诊断符合率为77.30%,临床乳腺外科检查诊断符合率为13.48%,钼靶X-线检查的诊断符合率为72.17%;3种技术联合检查诊断符合率可提高到96.93%,与各单项检查比较差异有统计学意义(P<0.05)。结论 超声诊断技术在乳腺癌的早期诊断中具有重要价值,结合临床外科检查、钼靶X线检查技术进行联合诊断将大大提高乳腺癌的早期诊断率。

The research of the early diagnosis for breast cancer by Ultrasonography

Objective To evaluate the value of the ultrasonography in the early diagnosis for breast cancer. Methods About 1 836 cases with small substantial masses （ ≤2 cm） in breast which were approved by operations and pathology in the same period, had been divided into three groups ： early breast cancer （ Group A）, non - early breast cancer （ Group B） and benign lesions （ Group C）. The data about the 2 - D image signs and color Doppler flow images of the 3 groups, the clinic surgical examinations and mammography X - ray, and the results of needle - cytology,operation and the pathology were statistically analyzed respectively. Results Compared to the benign lesions, ultrasonic sonogram of the breast cancer had 7 chief ultrasonic features ： the shape abnormity, spinose margin, the posterior echoes attenuated, longitudinal - transverse diameter ratio 〉 1, attenuation of sound in pone of masses,splendid vessels,and resistant index （ RI ） 〉 0. 70. The difference of ultrasonic features between the early breast cancer and non - early breast cancer was not significant（ P 〉 0. 05 ） In Group A, the diagnosis rate of ultrasonography, clinic surgery examinations and mammography X - ray was 77% , 13.48% ,70. 3% ,while the result was 97.0% when combining the three examinations. There was distinctively difference comparing with one of the three means （P 〈 0. 05）. Conclusion Uhrasonography has a significant value in the diagnosis of early breast cancer. Combining with clinic surgery examinations and mammography X - ray, ultrasonography will improve the success rate of diagnosis.