声触诊弹性成像、声触诊弹性测量联合血清糖类抗原153鉴别诊断BI-RADS 4类乳腺肿瘤的对比研究

目的 对比声触诊弹性成像（STE）联合血清糖类抗原153(CA153)与声触诊弹性测量（STQ）联合血清CA153鉴别诊断BI-RADS 4类、乳腺肿瘤良恶性的临床价值。方法 选取我院经手术病理确诊的乳腺肿瘤患者116例，均为BI-RADS 4类、单发病灶，其中恶性组45例和良性组71例，所有患者均于术前分别采用STE及STQ测量弹性模量值（以下简称STE、STQ测值），并检测血清CA153。比较STE及STQ测量成功率及不同操作者间的一致性；剔除STE或STQ测量失败的病例后，比较恶性组与良性组STE及STQ测值、血清CA153。绘制受试者工作特征（ROC）曲线分析STE测值、STQ测值、血清CA153单独及联合鉴别BI-RADS 4类乳腺肿瘤良恶性的诊断效能。结果 STE测量成功率为100%，明显高于STQ(89.66%)，差异有统计学意义（P<0.05）；不同操作者间STE测值的组间相关系数（ICC）高于STQ(0.932 vs.0.894)。剔除STQ测量失败的12例患者，剩余104例患者中恶性组39例，良性组65例；恶性组STE、STQ测值、血清CA153均高于良性组，...

Clinical value of STE and STQ combined with CA153 in the early identification of breast tumors of BI-RADS categories 3 to 5

Objective To analyze the clinical value of sound touch elastography (STE) and sound touch quantify (STQ) combined with carbohydrate antigen 153 (CA153) in the early identification of breast tumors of breast imaging reporting and data system (BI-RADS) categories 3 to 5. Methods The clinical data of 116 patients with breast tumors of BI-RADS categories 3 to 5 from January 2019 to December 2021 in the hospital were retrospectively analyzed. According to the results of surgical (or biopsy) pathological examinations, the patients were divided into malignant group (malignant tumors) and benign group (benign tumors). STE and STQ were used to measure the elasticity moduli of all patients before surgery, and serum CA153 was detected. The success rates of STE and STQ measurements and the consistency between different operators [inter-group correlation coefficient (ICC)] were compared. After excluding the cases with failed STE or STQ measurement, the elasticity moduli of STE measurement and STQ measurement and serum CA153 level were compared between the two groups. Receiver operating characteristic (ROC) curve was applied to evaluate the differential value of STE, STQ, serum CA153 and their combined detection on breast tumors of BI-RADS categories 3 to 5. Results The success rate of STE measurement was significantly higher than that of STQ (P<0.05), and its measurement consistency ICC coefficient was also higher than that of STQ (0.932 vs 0.894). After excluding the 12 patients with failed STQ measurement, the remaining 104 patients included 39 cases in malignant group and 65 cases in benign group. The elasticity modulus of STE or STQ measurement and serum CA153 level in malignant group were significantly higher than those in benign group (P<0.05). ROC curve analysis showed that the elasticity moduli measured by STE and STQ and serum CA153 had high differential value on malignant tumors among breast tumors of BI-RADS categories 3 to 5 (P<0.05), and the cut-off values were 4.28 m/s, 4.78 m/s and 23.43 U/mL. The combined detection of elasticity modulus measured by STE or STQ and serum CA153 had higher differential value than single detection, and their AUCs were 0.946 and 0.932 respectively. Conclusion The combined detection of elasticity modulus measured by STE or STQ and serum CA153 has higher identification value on breast tumors of BI-RADS categories 3 to 5, and STE collects more data and is more stable than STQ.