Ultrasound-guided needlebiopsy versus routine ultrasound examination in diagnosis of breast cancer
-
摘要: 目的 对比超声引导下粗针穿刺活检(UGCNB)与常规超声(US)检查在乳腺癌诊断中的价值。 方法 对82例拟诊为乳腺癌患者的临床资料进行回顾性分析,患者均接受UGCNB及US检查,观察乳腺良恶性病变超声表现差异。以手术病理结果为金标准,评估UGCNB及US检查对乳腺癌诊断的灵敏度(SE)、特异度(SP)、准确度(AC)、阳性预测值(PPV)及阴性预测值(NPV), 比较两者对乳腺癌的诊断价值。 结果 82例患者中,乳腺癌58例,乳腺良性病变24例。乳腺癌的超声图像主要表现为形态不规则,边界欠清晰,内部回声粗杂不均匀,后方回声衰减,常见微钙化,包膜不光整,血流信号多为Ⅱ~Ⅲ级,与乳腺良性病变比较有显著差异(P<0.01)。UGCNB诊断乳腺癌的SE、SP、AC、PPV、NPV显著高于US检查(P<0.05或P<0.01)。UGCNB与术后病理结果比较的Kappa值大于US检查。US检查与UGCNB诊断乳腺癌的关联性和优势性均有显著差异(P<0.05)。 结论 乳腺良恶性病变的超声表现差异显著, UGCNB对乳腺癌的诊断效能优于US检查,对提高乳腺癌诊断AC有重要意义。Abstract: Objective To compare the value of ultrasound-guided needle biopsy(UGCNB)versus routine ultrasound(US)in diagnosis of breast cancer. Methods The clinical data of 82 patients with probable breast cancer diagnosed in our hospital was retrospectively analyzed. All patients underwent US and UGBNB examinations, and the differences in ultrasound findings between benign and malignant breast lesions were observed. The surgical pathology results were taken as gold standards to evaluate the sensitivity(SE), specificity(SP), accuracy(AC), positive predictive value(PPV)and negative predictive value(NPV)of UGCNB and US in diagnosis of breast cancer, and the diagnostic value of two methods was compared. Results Of the 82 patients, 58 cases were diagnosed as breast cancer and 24 cases as benign breast lesions. Ultrasound images of breast cancer were mainly characterized by irregular shape, unclear boundary, coarse and heterogeneous internal echo, posterior echo attenuation, common microcalcification, non-smooth capsule and most blood flow signals of grade Ⅱ~Ⅲ, which showed significant differences when compared to the ultrasound findings of benign breast lesions(P<0.01). The SE, SP, AC, PPV and NPV of UGCNB in the diagnosis of breast cancer were higher than those of US(P<0.05 or P<0.01). Compared with postoperative pathology results, UGCNB showed a higher Kappa value than US. There were statistically significant differences - in the relevance and superiority between US and UGWNB in the diagnosis of breast cancer(P<0.05). Conclusion There are significant differences in ultrasound findings between benign and malignant breast lesions. UGCNB has better diagnostic efficacy than US in the diagnosis of breast cancer, and it is of great significance in improving the diagnostic accuracy of breast cancer.
-
Keywords:
- breast cancer /
- benign breast lesions /
- ultrasound guidance /
- needle biopsy /
- diagnostic efficacy
-
-
袁钦华, 俞士尤, 苏江. 86例乳腺癌骨转移的相关因素分析[J]. 实用癌症杂志, 2018, 33(10): 1717-1720. 封任冬, 汪华, 丁莹莹, 等. 乳腺癌筛查模式的探讨[J]. 临床放射学杂志, 2016, 35(1): 36-40. Durand M A, Hooley R J. Implementation of whole-breast screening ultrasonography[J]. Radiol Clin North Am, 2017, 55(3): 527-539.
何玉霜, 彭玉兰, 金亚, 等. 实时剪切波弹性成像联合超声BI-RADS诊断乳腺癌的Meta分析[J]. 西部医学, 2016, 28(4): 505-510. Takuwa H, Tsuji W, Yamamoto Y, et al. Multidisciplinary treatment for locally advanced breast cancer with internal mammary lymph node metastasis in an elderly patient[J]. Int Cancer Conf J, 2019, 8(1): 1-6.
Michelow P, Field A S. Spindle cell lesions of the breast on fine-needle aspiration biopsy: a miscellany of masses[J]. Acta Cytol, 2019, 63(4): 328-339.
耿琛琛, 高晓倩, 杨柳, 等. 乳腺硬化性腺病的超声表现分析[J]. 中国超声医学杂志, 2018, 34(4): 310-313. Faguy K. Breast sonography and mammography: complementarity and correlation[J]. Radiol Technol, 2017, 89(1): 45M-64M.
Imankulov S, Tuganbekov T, Razbadauskas A, et al. HIFU treatment for fibroadenoma-a clinical study at National Scientific Research Centre, Astana, Kazakhstan[J]. J Pak Med Assoc, 2018, 68(9): 1378-1380.
袁靖, 王绮, 郭海燕. 超声造影在乳腺癌疗效评估中的应用价值[J]. 实用癌症杂志, 2019, 34(3): 494-496. Hahn M, Fugunt R, Schoenfisch B, et al. High intensity focused ultrasound(HIFU)for the treatment of symptomatic breast fibroadenoma[J]. Int J Hyperthermia, 2018, 35(1): 463-470.
秦巧娜, 郑剑. 超声、MRI及其联合在乳腺癌患者诊断效能比较[J]. 中国CT和MRI杂志, 2017, 15(6): 69-71 , 86.
杨欢, 彭玉兰. 乳腺癌超声、MRI、X线征象与分子分型的相关性[J]. 中国医学影像技术, 2017, 33(5): 675-678. Brennan M E, McKessar M, Snook K, et al. Impact of selective use of breast MRI on surgical decision-making in women with newly diagnosed operable breast cancer[J]. Breast, 2017, 32: 135-143.
张美恋, 陈瑚, 薛恩生, 等. 乳腺复杂型纤维腺瘤的声像图特征及与浸润性导管癌的鉴别诊断[J]. 中国医学影像学杂志, 2017, 25(5): 365-369. Woodard S, Schetter S, Millington K. Diagnosis and imaging characteristics of a juvenile fibroadenoma in a 2-year-old patient: a case report[J]. Radiol Case Rep, 2018, 13(1): 6-10.
申俊玲, 李婷, 龚业琼, 等. 自动乳腺全容积扫描成像系统对乳腺肿块的诊断价值[J]. 西部医学, 2018, 30(11): 1675-1678 , 1685.
Kodera A, Inoue H, Ogura K, et al. Bevacizumab plus paclitaxel therapy was effective for metastatic breast cancer with dysphagia due to mediastinal lymph node metastasis-A case report[J]. Gan To Kagaku Ryoho, 2018, 45(13): 2276-2278.
张惠, 邓立强, 向素芳, 等. 超声及超声引导下粗针穿刺活检对妊娠期乳腺癌的诊断价值[J]. 实用妇产科杂志, 2016, 32(6): 453-455. Field A S, Raymond W A, Rickard M, et al. The international academy of cytology Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology[J]. Acta Cytol, 2019, 63(4): 257-273.
Fu Y Q, Guo F M, Chen H H, et al. Core needle biopsy promotes lung metastasis of breast cancer: an experimental study[J]. Mol Clin Oncol, 2019, 10(2): 253-260.
刘慧敏, 曹小丽, 刘瑞华. 超声引导下穿刺活检对乳腺癌前病变的诊断价值[J]. 中国医学影像技术, 2017, 33(5): 670-674. Bennett I C, Saboo A. The evolving role of vacuum assisted biopsy of the breast: a progression from fine-needle aspiration biopsy[J]. World J Surg, 2019, 43(4): 1054-1061.
杨艳, 童林燕, 何以敉, 等. 超声造影引导穿刺活检评价乳腺癌肝转移免疫组化指标的变化[J]. 中国超声医学杂志, 2017, 33(12): 1078-1080. Takahashi K. Diagnosis of an extremely rare pleomorphic adenoma of the breast with core needle biopsy: a case report[J]. Ann Med Surg(Lond), 2018, 36: 242-245.
Farshid G, Buckley E. Meta-analysis of upgrade rates in 3163 radial scars excised after needle core biopsy diagnosis[J]. Breast Cancer Res Treat, 2019, 174(1): 165-177.
韩丕华, 宋张骏, 杨晓民, 等. 超声造影对乳腺癌腋窝良恶性淋巴结的诊断价值分析[J]. 实用临床医药杂志, 2019, 23(16): 93-96. Yeo S H, Kim G R, Lee S H, et al. Comparison of ultrasound elastography and color Doppler ultrasonography for distinguishing small triple-negative breast cancer from fibroadenoma[J]. J Ultrasound Med, 2018, 37(9): 2135-2146.
Pillay S, Cheddie S, Moodley Y. Fibroadenoma of the breast in a South African population-a pilot study of the diagnostic accuracy of fine needle aspirate cytology and breast ultrasonography[J]. Afr Health Sci, 2018, 18(2): 273-280.
Nakhlis F, Harrison B T, Giess C S, et al. Evaluating the rate of upgrade to invasive breast cancer and/or ductal carcinoma in situ following a core biopsy diagnosis of non-classic lobular carcinoma in situ[J]. Ann Surg Oncol, 2019, 26(1): 55-61.
-
期刊类型引用(15)
1. 冯岩,程嘉,孟景茜. 超声引导下穿刺活检对早期乳腺癌的诊断价值. 癌症进展. 2024(04): 372-374 . 百度学术
2. 谭云. 乳腺导管原位癌经超声引导下粗针活检术诊断病理低估的相关因素分析. 影像研究与医学应用. 2024(12): 176-178 . 百度学术
3. 梁承友,王姗姗,姚德炯,钟欣航,李学坤,方舒. CT联合MRI引导下经皮肝穿刺在肝脏肿瘤中的临床应用. 影像研究与医学应用. 2024(17): 134-136+139 . 百度学术
4. 柳登平,程芳,刘芳,黄淑英. 高频超声联合超声引导下穿刺活检在乳腺BI-RADS 4B-5类肿块的价值分析. 医学信息. 2024(24): 129-132 . 百度学术
5. 金芬芬. 超声引导下细针穿刺活检在乳腺癌诊断中的应用. 现代医用影像学. 2024(11): 2127-2130 . 百度学术
6. 李建平,李云阶. CT诊断子宫内膜异位症的临床分析. 基层医学论坛. 2023(20): 102-104 . 百度学术
7. 栗玉姣,和秋艳. 超声引导下经皮肝脏穿刺活检术对肝脏占位病变患者的诊断价值. 贵州医药. 2023(09): 1438-1440 . 百度学术
8. 焦婷婷,全志伟. 基于深度学习的常规超声联合超声弹性成像诊断乳腺良恶性肿瘤的价值. 中国基层医药. 2023(09): 1406-1409 . 百度学术
9. 周晟,陈国明,贺曦,于琼,王进华. DBT联合DCE-MRI在致密型乳腺癌中应用价值研究. 临床放射学杂志. 2022(02): 255-259 . 百度学术
10. 黎秀娜,黄丹凤,刘美婷. 超声引导下穿刺活检对乳腺非肿块型病变的诊断价值. 临床医学. 2022(02): 73-74 . 百度学术
11. 陈俏利,区文财. 乳腺超声及超声引导粗针穿刺活检在乳腺癌诊断的价值. 现代医用影像学. 2022(03): 523-527 . 百度学术
12. 库朝阳. 超声引导下穿刺活组织检查对非肿块型乳腺癌的诊断价值. 中国实用医刊. 2022(10): 80-82 . 百度学术
13. 周国东. 乳腺钼靶X线对浸润性小叶癌与浸润性导管癌的鉴别诊断价值. 医疗装备. 2021(16): 19-20 . 百度学术
14. 宋国超,杨凯峰,孙英. 超声下穿刺活检、MRI检查对早期乳腺癌的诊断价值分析. 癌症进展. 2021(21): 2192-2194+2223 . 百度学术
15. 罗长芸,冉张申. 超声评估乳腺癌腋窝淋巴结转移的研究进展. 现代医学与健康研究电子杂志. 2021(22): 126-129 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 574
- HTML全文浏览量: 127
- PDF下载量: 8
- 被引次数: 15