彩超和钼靶X线定性诊断未触及肿块乳腺肿瘤的临床对比研究

摘要

Objective:　To evaluate the value of single or combined use of color doppler ultrasound and molyb -denum target X-ray in the early detection of non-palpable breast cancer.　Methods: To analyze the results of color doppler ultrasound and/or molybdenum target X-ray in detecting 143 female patients with suspicious masses.　The pathological results were included with the detection results as well.　Results:　The sensitivity of using color doppler ultrasound or molybdenum target X-ray alone and use of parallel or series were 81. 1% , 81. 1%, 95. 9%　and 66. 2% respectively. Their specificity were 88. 4% , 85. 5% , 84. 1% and 89. 9% respectively. And their accuracy were 84. 6% , 83. 2% , 90. 2% and 77. 6% respectively.　The false negative rates were 18. 9% , 18. 9% , 4. 1% and 33. 8% respectively.　The under-receiver operating characteristic (ROC) curve area for the diagnosis of non-palpable breast cancer were 0. 847, 0. 833 , 0. 900 and 0. 7800 respectively.　The accuracy of sequential use was lower than histopathology results　(P < 0. 05 ) , no statistics significance was found between the pathological results and the accuracy of using color Doppler ultrasound or molybdenum target X -ray alone or parallel application ( P > 0. 05 ).　The sensitivity of parallel application was higher than using color doppler ultrasound or molybdenum target X-ray alone and sequential use　( P < 0. 01) , and with the lowest false negative rates.　Conclusions: Parallel use of color doppler ultrasound and molybdenum target X -ray can be undertaken as the effective method for screening or diagnosing non-palpable early breast cancer.%目的:探讨彩色多普勒超声(彩超)和钼靶X线单独或联合使用对未触及肿块乳腺癌早期诊断的实用价值.方法:143例未触及肿块的可疑乳腺疾病患者均行彩超检查和钼靶X线摄影,对其单独或联合使用的结果进行分析,并与病理结果进行对照.结果:彩超、钼靶X线和两者并联、串联的灵敏度分别为81.1%、81.1%、95.9%和66.2%,特异度分别为88.4%、85.5%、84.1%和89.9%,准确率分别为84.6%、83.2%、90.2%和77.6%,假阴性率分别为18.9%、18.9%、4.1%和33.8%,受试者工作特征曲线下面积依次为0.847、0.833、0.900和0.780.串联的准确率低于病理结果(P<0.05),彩超、钼靶X线、并联的准确率分别与病理结果比较,差异均无统计学意义(P均>0.05),但并联的灵敏度高于彩超、钼靶X线单独使用或串联使用(P<0.01,P<0.01,P<0.001),并且假阴性率最低.结论:彩超和钼靶X线并联应用可作为未触及肿块乳腺癌的有效筛查和诊断方法.