{"title":"钩丝定位乳腺良恶性结节的超声特征及超声与钼靶x线诊断价值分析","authors":"R. Guo, Yuxiang Wang","doi":"10.3760/CMA.J.ISSN.1006-9801.2020.02.010","DOIUrl":null,"url":null,"abstract":"目的 \n分析导丝定位后手术切除不能触及的乳腺良恶性病变的超声特征及超声与钼靶的诊断效能。 \n \n \n方法 \n选取山西省肿瘤医院2011年3月至2018年10月经超声引导下导丝定位后行手术切除的324例不能触及的乳腺结节患者，回顾性分析超声检查发现且不能触及的乳腺良恶性病变的超声及钼靶检查结果。 \n \n \n结果 \n58例恶性病变患者中浸润性导管癌33例，导管原位癌14例，小叶原位癌1例，浸润性小叶癌3例，浸润性导管癌合并导管内癌4例，黏液癌1例，髓样癌1例，浸润性导管癌合并浸润性小叶癌及导管原位癌1例。266例良性病变患者中纤维瘤167例，乳腺腺病61例，乳管内乳头状瘤31例，导管扩张5例，炎症性病变2例。边缘不完整、伴钙化这两个超声特征在判断不可触及的乳腺结节的良恶性中差异均有统计学意义（χ2=129.155，P<0.001；χ2=11.834，P=0.001）。以4B为良恶性的界值，超声的诊断灵敏度84.5%，特异度91.0%，阳性预测值67.1%；钼靶的诊断灵敏度77.6%，特异度93.2%，阳性预测值71.4%。钼靶和超声联合使用灵敏度93.1%，特异度86.8%，阳性预测值60.7%。 \n \n \n结论 \n不能触及的乳腺结节较难诊断，超声检查有助于鉴别诊断。超声诊断对不能触及的乳腺病变的灵敏度较高，钼靶的特异度较高，钼靶和超声联合使用能提高诊断灵敏度。","PeriodicalId":9505,"journal":{"name":"肿瘤研究与临床","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ultrasonographic characteristics of hook wire-localized impalpable benign and malignant breast nodules and the diagnostic value analysis of ultrasonogragh and mammography\",\"authors\":\"R. Guo, Yuxiang Wang\",\"doi\":\"10.3760/CMA.J.ISSN.1006-9801.2020.02.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"目的 \\n分析导丝定位后手术切除不能触及的乳腺良恶性病变的超声特征及超声与钼靶的诊断效能。 \\n \\n \\n方法 \\n选取山西省肿瘤医院2011年3月至2018年10月经超声引导下导丝定位后行手术切除的324例不能触及的乳腺结节患者，回顾性分析超声检查发现且不能触及的乳腺良恶性病变的超声及钼靶检查结果。 \\n \\n \\n结果 \\n58例恶性病变患者中浸润性导管癌33例，导管原位癌14例，小叶原位癌1例，浸润性小叶癌3例，浸润性导管癌合并导管内癌4例，黏液癌1例，髓样癌1例，浸润性导管癌合并浸润性小叶癌及导管原位癌1例。266例良性病变患者中纤维瘤167例，乳腺腺病61例，乳管内乳头状瘤31例，导管扩张5例，炎症性病变2例。边缘不完整、伴钙化这两个超声特征在判断不可触及的乳腺结节的良恶性中差异均有统计学意义（χ2=129.155，P<0.001；χ2=11.834，P=0.001）。以4B为良恶性的界值，超声的诊断灵敏度84.5%，特异度91.0%，阳性预测值67.1%；钼靶的诊断灵敏度77.6%，特异度93.2%，阳性预测值71.4%。钼靶和超声联合使用灵敏度93.1%，特异度86.8%，阳性预测值60.7%。 \\n \\n \\n结论 \\n不能触及的乳腺结节较难诊断，超声检查有助于鉴别诊断。超声诊断对不能触及的乳腺病变的灵敏度较高，钼靶的特异度较高，钼靶和超声联合使用能提高诊断灵敏度。\",\"PeriodicalId\":9505,\"journal\":{\"name\":\"肿瘤研究与临床\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-02-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"肿瘤研究与临床\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1006-9801.2020.02.010\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"肿瘤研究与临床","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1006-9801.2020.02.010","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
Objective: To analyze the ultrasound characteristics and diagnostic efficacy of ultrasound and molybdenum target in the removal of untouchable benign and malignant breast lesions after guided wire positioning surgery. Method: A retrospective analysis was conducted on 324 patients with untouchable breast nodules who underwent surgical resection under the guidance of ultrasound guided guide wire from March 2011 to October 2018 at Shanxi Provincial Cancer Hospital. The results of ultrasound and molybdenum target examinations were retrospectively analyzed for benign and malignant breast lesions that were found to be untouchable by ultrasound examination. Among the 58 patients with malignant lesions, there were 33 cases of invasive ductal carcinoma, 14 cases of ductal carcinoma in situ, 1 case of lobular carcinoma in situ, 3 cases of invasive lobular carcinoma, 4 cases of invasive ductal carcinoma combined with ductal carcinoma, 1 case of mucinous carcinoma, 1 case of medullary carcinoma, and 1 case of invasive ductal carcinoma combined with invasive lobular carcinoma and ductal carcinoma in situ. Among 266 patients with benign lesions, 167 were fibromas, 61 were breast adenomas, 31 were intraductal papillomas, 5 were ductal dilation, and 2 were inflammatory lesions. The difference between the two ultrasound features of incomplete margin and calcification in determining the benign and malignant status of untouchable breast nodules is statistically significant（ χ 2=129.155, P<0.001; χ 2=11.834, P=0.001). Taking 4B as the boundary value for benign and malignant tumors, the diagnostic sensitivity of ultrasound is 84.5%, the specificity is 91.0%, and the positive predictive value is 67.1%; The diagnostic sensitivity of molybdenum target is 77.6%, specificity is 93.2%, and positive predictive value is 71.4%. The combination of molybdenum target and ultrasound has a sensitivity of 93.1%, a specificity of 86.8%, and a positive predictive value of 60.7%. Conclusion: Non palpable breast nodules are difficult to diagnose, and ultrasound examination is helpful in differential diagnosis. Ultrasound diagnosis has a high sensitivity for breast lesions that cannot be touched, and the specificity of molybdenum targets is high. The combination of molybdenum targets and ultrasound can improve diagnostic sensitivity.
Ultrasonographic characteristics of hook wire-localized impalpable benign and malignant breast nodules and the diagnostic value analysis of ultrasonogragh and mammography
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