Comparison of ultrasound "firefly" technique and mammography in the diagnosis of breast intraductal carcinoma in situ
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摘要:
目的 探讨超声“萤火虫”技术与X线钼靶摄影对乳腺导管内原位癌(DCIS)的临床应用价值。 方法 选取2019年12月~ 2021年12月收治的疑似乳腺导管内原位癌患者98例作为研究对象。98例患者均在本院行手术治疗，术前均行超声“萤火虫”技术及X线钼靶检查，统计两种检查对乳腺导管内原位癌的检出情况，以病理诊断作为金标准，对两种影像学检查方式进行对比，比较单一检查与联合检查的诊断价值。 结果 98例乳腺导管内原位癌患者均为单发病灶，良性病变59例，恶性病变39例。超声“萤火虫”技术对乳腺导管内原位癌诊断的敏感度较X线钼靶高(71.8% vs 61.5%)，特异性较X线钼靶低(66.1% vs 76.3%)，但两者对乳腺DCIS的诊断价值差异无统计学意义(P > 0.05)。超声“萤火虫”技术联合X线钼靶对乳腺DCIS诊断的敏感度、特异性和准确度分别为92.3%、91.5%及91.8%，均高于单纯超声“萤火虫”技术诊断(71.8%、66.1%、68.4%)和单纯X线钼靶(61.5%、76.3%、70.4%)，差异有统计学意义(P < 0.05)。 结论 超声“萤火虫”技术联合X线钼靶摄影在诊断乳腺DCIS时具有较高敏感度、特异性和准确度，有助于提高乳腺DCIS的诊断准确率，为临床诊断提供更多价值。 Abstract:Objective To investigate the clinical value of ultrasound "firefly" technique and X-ray mammography for ductal carcinoma in situ (DCIS) of the breast. Methods A total of 98 patients with suspected breast intraductal carcinoma in situ admitted from December 2019 to December 2021 were selected as the research objects. All 98 patients underwent surgical treatment in our hospital. Before operation, ultrasound "firefly" technology and X-ray molybdenum target examination were performed. The detection of intraductal carcinoma in situ of breast was statistically analyzed. Results All 98 cases of breast intraductal carcinoma in situ were single lesions, 59 cases were benign lesions, 39 cases were malignant lesions. The sensitivity of ultrasound "firefly" in the diagnosis of breast ductal carcinoma in situ was higher than that of X-ray mammography (71.8% vs 61.5%), and the specificity was lower than that of X-ray mammography (66.1% vs 76.3%). There was no significant difference in the diagnostic value of ultrasound "firefly" in breast DCIS (P > 0.05). The sensitivity, specificity and accuracy of ultrasound "firefly" technique combined with X-ray mammography in the diagnosis of breast DCIS were 92.3%, 91.5% and 91, 8%, respectively, which were higher than those of ultrasound "firefly" technique alone (71.8%, 66.1% and 68.4%) and X-ray mammography alone (61.5%, 76.3% and 70.4%), the difference was statistically significant (P < 0.05). Conclusion Ultrasound "firefly" technology combined with X-ray mammography has high sensitivity, specificity and accuracy in the diagnosis of breast DCIS, which is helpful to improve the diagnostic accuracy of breast DCIS and provide more value for clinical diagnosis. -
表 1 三种检测方法诊断乳腺DCIS的病理结果
Table 1. Pathological results of three detection methods in the diagnosis of breast DCIS (n)
病理检查 “萤火虫”检测 钼靶检测 联合检测 合计 阳性 阴性 阳性 阴性 阳性 阴性 阳性 28 11 24 15 36 3 39 阴性 20 39 14 45 5 54 59 合计 48 50 38 60 41 57 98 
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表 2 三种检测方法的敏感度、特异性及准确度比较
Table 2. Comparison of sensitivity, specificity and accuracy of the three detection methods
指标 “萤火虫”检测(%) 钼靶检测(%) 联合检测(%) χ2a Pa χ2b Pb χ2c Pc 敏感度 71.8(28/39) 61.5(24/39) 92.3(36/39) 0.519 0.431 4.266 0.039 8.739 0.003 特异性 66.1(39/59) 76.3(45/59) 91.5(54/59) < 0.001 1.000 9.948 0.002 11.105 0.001 准确度 68.4(67/98) 70.4(69/98) 91.8(90/98) 0.070 0.791 15.493 < 0.001 12.539 < 0.001 a: “萤火虫”检测vs钼靶检测; b: “萤火虫”检测vs联合检测; c: 钼靶检测vs联合检测.
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