超声联合钼靶X线对直径小于1 cm的乳腺癌诊断价值分析

目的:探讨超声联合钼靶X线对直径小于1 cm的乳腺癌诊断价值。方法:选择我院2012年1月至2017年12月收治的66例乳腺疾病患者,所有患者术前均经钼靶X线及彩色多普勒超声检查,分析其病理结果,分析钼靶X线、彩色多普勒超声及二者联合对乳腺肿块的检查结果(边缘毛刺征、血管、淋巴结、微小钙化),比较其对乳腺癌的灵敏度、特异度、准确度、阳性预测值及阴性预测值。结果:66例患者中,经病理检查发现恶性肿瘤34例,良性肿瘤32例。与病理检测相比,彩色多普勒超声联合钼靶X线对乳腺肿块的良恶性检出率无差异性(P0.05),而彩色多普勒超声,钼靶X线的良恶性检出率均显著降低(P0.05)。彩色多普勒超声与钼靶X线良恶性检出率对比无差异(P0.05),但均低于彩色多普勒超声联合钼靶X线的检出率(P0.05)。彩色多普勒超声与钼靶X线对乳腺癌的边缘毛刺征的检出率对比无统计学意义(P0.05);彩色多普勒超声对血管和淋巴结的检出率明显高于钼靶X线,而微小钙化的检出率明显低于钼靶X线,对比差异有统计学意义(P0.05)。彩色多普勒超声联合钼靶X线的灵敏度、特异度、准确度、阳性预测值及阴性预测值均明显高于彩色多普勒超声及钼靶X线(P0.05),钼靶X线及彩色多普勒超声间对比无统计学意义(P0.05)。结论:彩色多普勒超声与钼靶X线对直径小于1 cm乳腺癌的诊断各有优势,二者联合应用的诊断价值优于单一诊断方法。

The Diagnostic Value of Ultrasound Combined with Mammography X-ray for Breast Cancer Less than 1 cm in Diameter

ABSTRACT Objective: To investigate the diagnostic value of ultrasound combined with mammography x-ray for breast cancer less than 1cm in diameter. Methods: 66 cases with breast disease patient from Jan. 2012 to Dec. 2017 in our hospital were chosen, who were performed by molybdenum target X-ray and color doppler ultrasonography before operation, the pathologic result were analyzed, the breast masses results(marginal burr, blood vessels, lymph node, microcalcification) of molybdenum target X-ray, color doppler ultrasound and combination of the two methods were analyzed. The sensitivity, specificity, accuracy, positive predictive value and negative predic- tive value of molybdenum target X-ray, color doppler ultrasound and combination of the two methods were compared. Results: Among the 66 cases, 34 were malignant and 32 were benign. Compared with pathological examination, the detection rate of benign and malig- nant by color doppler ultrasound combined with molybdenum target X-ray had no difference(P>0.05), but the detection rate of benign and malignant breast by color doppler ultrasound and molybdenum target X-ray were significantly lower(P<0.05). There was no signifi- cant difference between color doppler ultrasound and molybdenum target X-ray(P>0.05), but the detection rate was lower than that of color doppler ultrasound combined with molybdenum target X-ray(P<0.05). There was no significant difference between color doppler ultrasound and molybdenum target X-ray in detecting marginal burr of breast cancer(P>0.05). The detection rate of blood vessels and lymph nodes by color doppler ultrasound was significantly higher than that by molybdenum target X-ray, while the detection rate of mi- crocalcification was significantly lower than that by molybdenum target X-ray(P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of color doppler ultrasound combined with molybdenum target X-ray were significantly higher than those of color doppler ultrasound and molybdenum target X-ray(P<0.05). There was no significant difference between molyb- denum target X-ray and color doppler ultrasound (P>0.05). Conclusion: Both color doppler ultrasound and molybdenum target X-ray had advantages in the diagnosis of breast cancer with diameter less than 1 cm, while the combined diagnosis was superior to the single diagnosis.