乳腺导管内癌患者高频彩色多普勒超声与X线摄片检查早期诊断价值比较
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摘要
【目的】比较导管内癌患者高频彩色多普勒超声与X线摄片检查的影像学征象及早期诊断价值。【方法】收集湖州市中心医院55例经手术和病理结果证实为导管内癌患者的临床资料,回顾性分析其影像学资料,包括高频彩色多普勒超声与X线摄片检查,比较两种影像学方法导管内癌影像学征象及其早期诊断价值。【结果】55例患者中,经高频彩色多普勒超声检查具有导管内癌表现28例,诊断准确率为50.9%;经X线摄片检查具有导管内癌表现39例,诊断准确率为70.9%。经统计结果显示,经X线摄片检查对导管内癌诊断准确率较高频彩色多普勒超声检查明显升高(P=0.049)。X线摄片检查诊断肿瘤微钙化的准确率为67.3%,较彩超检查的47.3%明显升高(P=0.034)。结合彩超与X线摄片诊断为导管内癌共43例,诊断准确率明显提高,为78.2%。【结论】乳腺X线摄片对导管内癌的早期诊断价值明显优于高频彩色多普勒超声检查,临床中可联合这两种影像学检查方法以起到优势互补、取长补短的作用,有助于提高对导管内癌的诊断准确率,降低漏诊率。
【Objective】To compare the imaging features and early diagnostic value of high frequency color Doppler ultrasonography and X-ray mammography in patients with breast carcinoma in situ.【Methods】The clinical data of 55 patients with breast carcinoma in situ confirmed by operation and pathology were collected and analyzed retrospectively,including high frequency color Doppler ultrasonography and X-ray mammography.【Results】Among 55 cases,28 cases were diagnosed as breast carcinoma in situ by high frequency color Doppler ultrasonography,with the diagnostic accuracy rate of 50.9%;39 cases were diagnosed as breast carcinoma in situ by X-ray mammography,with the diagnostic accuracy rate of 70.9%. Statistical results showed that the diagnostic accuracy of mammography for breast carcinoma in situ was significantly higher than that of high frequency color Doppler ultrasonography(P=0.049). The diagnostic accuracy of Xray mammography was 67.3% and that of high frequency color Doppler ultrasonography was 47.3%(P=0.034). 43 cases of breast carcinoma in situ were diagnosed by color Doppler ultrasonography and X-ray mammography,and the diagnostic accuracy was 78.2%,which increased significantly.【Conclusions】X-ray mammography is superior to high-frequency color Doppler ultrasonography in the early diagnosis of breast carcinoma in situ. The combination of the two imaging methods can play a complementary role in improving the accuracy of diagnosis of breast carcinoma in situ and reducing the rate of missed diagnosis.
【Objective】To compare the imaging features and early diagnostic value of high frequency color Doppler ultrasonography and X-ray mammography in patients with breast carcinoma in situ.【Methods】The clinical data of 55 patients with breast carcinoma in situ confirmed by operation and pathology were collected and analyzed retrospectively,including high frequency color Doppler ultrasonography and X-ray mammography.【Results】Among 55 cases,28 cases were diagnosed as breast carcinoma in situ by high frequency color Doppler ultrasonography,with the diagnostic accuracy rate of 50.9%;39 cases were diagnosed as breast carcinoma in situ by X-ray mammography,with the diagnostic accuracy rate of 70.9%. Statistical results showed that the diagnostic accuracy of mammography for breast carcinoma in situ was significantly higher than that of high frequency color Doppler ultrasonography(P=0.049). The diagnostic accuracy of Xray mammography was 67.3% and that of high frequency color Doppler ultrasonography was 47.3%(P=0.034). 43 cases of breast carcinoma in situ were diagnosed by color Doppler ultrasonography and X-ray mammography,and the diagnostic accuracy was 78.2%,which increased significantly.【Conclusions】X-ray mammography is superior to high-frequency color Doppler ultrasonography in the early diagnosis of breast carcinoma in situ. The combination of the two imaging methods can play a complementary role in improving the accuracy of diagnosis of breast carcinoma in situ and reducing the rate of missed diagnosis.
引文
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[6]冯爱强,李庆辉,张彦武,等.乳腺导管原位癌伴微浸润的预后及其影响因素分析[J].山东医药,2015,55(37):66-68.Feng AQ,Li QH,Zhang YW et al. Prognosis andinfluencing factors of breast ductal carcinoma in situwith microinvasion[J]. Shandong Med J,2015,55(37):66-68.
[7] Borgquist S, Zhou W, Jirstr?m K, et al. Theprognostic role of HER2 expression in ductal breastcarcinoma in situ(DCIS);a population-basedcohort study[J]. Bmc Cancer,2015,15(1):468.
[8] Leong LC,Sim LS,Jaralazaro AR,et al. Ultrasoundbreast elastographic evaluation of mass-formingductal carcinoma-in-situ with histologicalcorrelation-New findings for a toothpaste sign[J].Asian Pac J Cancer Prev,2016,17(5):2673-2678.
[9] Zhou W,Sollie T,Tot T,et al. Ductal breastcarcinoma in situ:Mammographic features and itsrelation to prognosis and tumour biology in apopulation based cohort[J]. Int J Breast Cancer,2017,4351319.
[10]张玲.超声联合钼靶X线在乳腺原位癌伴早期浸润中的诊断价值[J].医学临床研究,2016,33(11):2181-2183.Zhang L. Diagnostic value of ultrasound combinedwith mammography in early breast cancer with earlyinvasion[J]. Med Clin Res,2016,33(11):2181-2183.
[11]Vernet-Tomas M, Mojal S, Gamero R, et al.Mammographic extent of microcalcifications andoestrogen receptor expression affect preoperativebreast carcinoma in situ size estimation[J]. BreastCancer,2016,24(3):1-7.
[12]刘云霄,赵丽平.乳腺钙化与乳腺病变病理学类型分析[J].中国实用医刊,2016,43(21):46-48.Liu YX, Zhao LP. Pathological types of breastcalcification and breast lesions[J]. Chin J PracMed,2016,43(21):46-48.
[13]Jin ZQ, Lin MY, Hao WQ, et al. Diagnosticevaluation of ductal carcinoma in situ of the breast:ultrasonographic,mammographicandhistopathologic correlations[J]. Ultrasound MedBiol,2015,41(1):47-55.
[14]张伟民.高频超声联合钼靶X线摄影诊断乳腺肿块的效果和价值[J].中国实用医刊,2016,43(22):120-122.Zhang WM. The effect and value of high frequencyultrasound combined with mammography in thediagnosis of breast masses[J]. Chin J Prac Med,2016,43(22):120-122.
[15]Watanabe T,Yamaguchi T,Tsunoda H,et al.Ultrasound image classification of ductal carcinomain situ(DCIS)of the breast:Analysis of 705 DCISlesions[J]. Ultrasound in Med Biol,2017,43(5):918-924.
[16]吴琬璐,方向明,陈宏伟,等.乳腺癌分子成像研究进展[J].国际医学放射学杂志,2017,40(1):68-75.Wu WL,Fang XM,Chen HW,et al. Advances inmolecular imaging of breast cancer[J]. Int J MedRadiol,2017,40(1):68-75.
[2]陈传志,马瑞民,郭贵龙,等.乳腺导管内原位癌的诊疗[J].国际肿瘤学杂志,2016,43(4):302-305.Chen CZ,Ma RM,Guo GL,et al. The diagnosisand treatment of breast ductal carcinoma in situ[J].J Int Oncol,2016,43(4):302-305.
[3] Nishijima T,Yamamoto H,Nakano T,et al. Low-grade intraductal carcinoma(low-grade cribriformcystadenocarcinoma)with tumor-associatedlymphoid proliferation of parotid gland[J]. PatholRes Pract,2017,213(6):706-709.
[4]刘思吟,张明帅,王晓文,等.乳腺导管原位癌伴微小浸润的临床分析[J].中华肿瘤防治杂志,2016,23(15):1000-1005.Liu SY, Zhang MS, Wang XW, et al.Clinicopathologic study of breast ductal carcinomain situ with microinvasion[J]. Chin J Cancer PrevTreat,2016,23(15):1000-1005.
[5]李贤华,王兵.乳腺钼靶X线摄影检查联合磁共振成像诊断乳腺导管原位癌的有效性[J].中国计划生育和妇产科,2018,10(2):64-66;71.Li XH, Wang B. The value of mammographycombined with magnetic resonance imaging in thediagnosis of ductal carcinoma in situ[J]. Chin JFamily Planning&Gynecotokol,2018,10(2):64-66,71.
[6]冯爱强,李庆辉,张彦武,等.乳腺导管原位癌伴微浸润的预后及其影响因素分析[J].山东医药,2015,55(37):66-68.Feng AQ,Li QH,Zhang YW et al. Prognosis andinfluencing factors of breast ductal carcinoma in situwith microinvasion[J]. Shandong Med J,2015,55(37):66-68.
[7] Borgquist S, Zhou W, Jirstr?m K, et al. Theprognostic role of HER2 expression in ductal breastcarcinoma in situ(DCIS);a population-basedcohort study[J]. Bmc Cancer,2015,15(1):468.
[8] Leong LC,Sim LS,Jaralazaro AR,et al. Ultrasoundbreast elastographic evaluation of mass-formingductal carcinoma-in-situ with histologicalcorrelation-New findings for a toothpaste sign[J].Asian Pac J Cancer Prev,2016,17(5):2673-2678.
[9] Zhou W,Sollie T,Tot T,et al. Ductal breastcarcinoma in situ:Mammographic features and itsrelation to prognosis and tumour biology in apopulation based cohort[J]. Int J Breast Cancer,2017,4351319.
[10]张玲.超声联合钼靶X线在乳腺原位癌伴早期浸润中的诊断价值[J].医学临床研究,2016,33(11):2181-2183.Zhang L. Diagnostic value of ultrasound combinedwith mammography in early breast cancer with earlyinvasion[J]. Med Clin Res,2016,33(11):2181-2183.
[11]Vernet-Tomas M, Mojal S, Gamero R, et al.Mammographic extent of microcalcifications andoestrogen receptor expression affect preoperativebreast carcinoma in situ size estimation[J]. BreastCancer,2016,24(3):1-7.
[12]刘云霄,赵丽平.乳腺钙化与乳腺病变病理学类型分析[J].中国实用医刊,2016,43(21):46-48.Liu YX, Zhao LP. Pathological types of breastcalcification and breast lesions[J]. Chin J PracMed,2016,43(21):46-48.
[13]Jin ZQ, Lin MY, Hao WQ, et al. Diagnosticevaluation of ductal carcinoma in situ of the breast:ultrasonographic,mammographicandhistopathologic correlations[J]. Ultrasound MedBiol,2015,41(1):47-55.
[14]张伟民.高频超声联合钼靶X线摄影诊断乳腺肿块的效果和价值[J].中国实用医刊,2016,43(22):120-122.Zhang WM. The effect and value of high frequencyultrasound combined with mammography in thediagnosis of breast masses[J]. Chin J Prac Med,2016,43(22):120-122.
[15]Watanabe T,Yamaguchi T,Tsunoda H,et al.Ultrasound image classification of ductal carcinomain situ(DCIS)of the breast:Analysis of 705 DCISlesions[J]. Ultrasound in Med Biol,2017,43(5):918-924.
[16]吴琬璐,方向明,陈宏伟,等.乳腺癌分子成像研究进展[J].国际医学放射学杂志,2017,40(1):68-75.Wu WL,Fang XM,Chen HW,et al. Advances inmolecular imaging of breast cancer[J]. Int J MedRadiol,2017,40(1):68-75.