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网络出版:2024-03-07,
纸质出版:2024-03-07
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钟丽萍,黄雪梅,汪姝妤,等. 超声弹性成像联合UGCNB对乳腺病灶的诊断价值[J]. 肿瘤影像学, 2024, 33(1): 62-68 https://doi.
org/10.19732/j.cnki.2096-6210.2024.01.009
钟丽萍,黄雪梅,汪姝妤,等. 超声弹性成像联合UGCNB对乳腺病灶的诊断价值[J]. 肿瘤影像学, 2024, 33(1): 62-68 https://doi. DOI: 10.19732/j.cnki.2096-6210.2024.01.009.
org/10.19732/j.cnki.2096-6210.2024.01.009 DOI:
目的:
探究超声弹性成像(Ultarsonic elastography,UE)联合超声引导下空芯针穿刺活检(ultrasound-guided core needle biopsy,UGCNB)诊断乳腺病灶良恶性的价值,以及与术后病理学检查结果的一致性。
方法:
选取2020年10月—2022年10月自贡市第一人民医院98例疑似乳腺癌患者,均行UE、UGCNB检查,以术后病理学检查结果为“金标准”。比较乳腺良性肿瘤与乳腺癌患者UE定量参数[弹性应变率(strain ratio,SR)、面积比(area ratio,AR)],并比较不同临床特征乳腺癌患者UE定量参数,分析UE定量参数与乳腺癌临床特征的相关性,通过受试者工作特征(receiver operating characteristic,ROC)曲线分析UE定量参数诊断乳腺病灶良恶性的价值,并分析UE、UGCNB单独及联合诊断乳腺病灶良恶性与术后病理学检查结果的一致性。
结果:
98例疑似乳腺癌患者经术后病理学检查检出乳腺癌53例,其中经UE检出乳腺癌46例,经UGCNB检出乳腺癌50例。乳腺癌患者SR、AR均较乳腺良性肿瘤患者高(
P
<0.05)。不同临床分期、淋巴结转移状态、雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)表达及Ki-67增殖指数下乳腺癌患者SR、AR比较差异有统计学意义(
P
<0.05)。SR、AR与乳腺癌高临床分期、淋巴结转移、HER2、Ki-67增殖指数呈正相关,与ER、PR阳性表达呈负相关(
P
<0.05)。SR、AR单独诊断的曲线下面积(area under curve,AUC)分别为0.715、0.682,联合诊断的AUC为0.849。UE单独诊断乳腺病灶良恶性与术后病理学检查结果一致性为0.655,UGCNB单独诊断与术后病理学检查结果一致性为0.939,联合诊断与术后病理学检查结果的一致性为0.979,且联合诊断的准确度均较UE单独诊断高(
P
<0.05)。
结论:
UE联合UGCNB检查可有效地提高乳腺癌术前诊断准确度,为临床早期定性诊断、评估病情及制订干预方案提供依据。
Objective:
To investigate the value of ultrasound elastography (UE) combined with ultrasound-guided core needle biopsy (UGCNB) in the diagnosis of benign and malignant breast lesions
and the consistency with postoperative pathological findings.
Methods:
A total of 98 patients with suspected breast cancer from October 2020 to October 2022 were selected and examined by UE and UGCNB
and the postoperative pathological findings were used as the “gold standard”. The quantitative parameters of UE [strain ratio (SR) and area ratio (AR)] were compared between benign breast tumors and breast cancer patients
and the correlation between quantitative parameters of UE and clinical characteristics of breast cancer was analyzed. The receiver operating characteristic (ROC) curve was used to analyze the value of UE quantitative parameters in diagnosing the benign and malignant breast lesions
and to analyze the consistency of UE and UGCNB alone and in combination with postoperative pathological findings.
Results:
In 98 cases of suspected breast cancer
53 cases of breast cancer were detected by postoperative pathology
46 cases of breast cancer were detected by UE
and 50 cases of breast cancer were detected by UGCNB. SR and AR of breast cancer patients were higher than benign breast tumor patients (
P
0.05). The expression of SR and AR in breast cancer patients with differentclinical stages
lymph node metastasis status
the positive expression of estrogen receptor (ER)
progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2)
Ki-67 proliferation index were significantly different (
P
0.05). SR and AR were positively correlated with the high clinical stage
lymph node metastasis
HER2
+
Ki-67 proliferation index of breast cancer
and negatively correlated with ER
+
and PR
+
(
P
0.05). The area under curves (AUCs) for individual diagnosis of SR and AR were 0.715 and 0.682
respectively
while the AUC for combine
d diagnosis was 0.849. The consistency between UE alone diagnosis of benign and malignant breast lesions and postoperative pathologic examination results was 0.655
and the consistency between UGCNB alone diagnosis and postoperative pathologic examination results was 0.939
and the consistency between the combined diagnosis and postoperative pathologic examination results was 0.979
and the accuracy of the combined diagnosis was higher than that of UE alone (
P
0.05).
Conclusion:
UE combined with UGCNB examination can effectively improve the accuracy of preoperative diagnosis of breast cancer
and provide a basis for early clinical qualitative diagnosis
disease assessment and intervention plan formulation.
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