浙江预防医学
浙江預防醫學
절강예방의학
ZHEJIANG JOURNAL OF PREVENTIVE MEDICINE
2014年
5期
454-458
,共5页
乳腺癌筛查%超声%钼靶
乳腺癌篩查%超聲%鉬靶
유선암사사%초성%목파
Breast cancer screening%Ultrasound%Mammography
目的：研究 ROC 曲线分析法评价乳腺临床检查、乳腺超声检查（US）、钼靶 X 线检查（MAM）及这3项检查综合分级在乳腺癌筛查中的诊断价值，为农村地区开展乳腺癌筛查选择适宜技术。方法采用问卷调查和乳腺临床检查，对乳腺癌高危人群采用乳腺超声和钼靶 X 线检查进行乳腺癌筛查，利用 ROC 曲线分析法评价临床检查、超声、钼靶 X 线检查及各项联合检查（综合检查）在乳腺癌筛查中的灵敏度和特异性。结果在23910名接受乳腺癌筛查的农村妇女中，病理确诊乳腺癌31例，乳腺癌检出率为129.65/10万。乳腺综合检查的灵敏度、特异性及 ROC 曲线下面积分别为90.323、94.605和0.954；超声检查的灵敏度、特异性及 ROC 曲线下面积分别为70.968、90.288和0.814；钼靶 X 线检查的灵敏度、特异性及 ROC 曲线下面积分别为74.194、91.727和0.850；临床检查的灵敏度、特异性及 ROC 曲线下面积分别为41.935、82.734和0.676。其 ROC 曲线下面积（AUC）比较经 Z 检验，综合检查 F 分级评价诊断优于其他各项检查的准确性（P ＜0.05），超声与钼靶X 线检查诊断准确性比较差异无统计学意义（P ＞0.05）。结论乳腺超声和钼靶 X 线检查是乳腺癌筛查的有效方法，而综合检查分级评价方法能明显提高乳腺癌的诊断能力。
目的：研究 ROC 麯線分析法評價乳腺臨床檢查、乳腺超聲檢查（US）、鉬靶 X 線檢查（MAM）及這3項檢查綜閤分級在乳腺癌篩查中的診斷價值，為農村地區開展乳腺癌篩查選擇適宜技術。方法採用問捲調查和乳腺臨床檢查，對乳腺癌高危人群採用乳腺超聲和鉬靶 X 線檢查進行乳腺癌篩查，利用 ROC 麯線分析法評價臨床檢查、超聲、鉬靶 X 線檢查及各項聯閤檢查（綜閤檢查）在乳腺癌篩查中的靈敏度和特異性。結果在23910名接受乳腺癌篩查的農村婦女中，病理確診乳腺癌31例，乳腺癌檢齣率為129.65/10萬。乳腺綜閤檢查的靈敏度、特異性及 ROC 麯線下麵積分彆為90.323、94.605和0.954；超聲檢查的靈敏度、特異性及 ROC 麯線下麵積分彆為70.968、90.288和0.814；鉬靶 X 線檢查的靈敏度、特異性及 ROC 麯線下麵積分彆為74.194、91.727和0.850；臨床檢查的靈敏度、特異性及 ROC 麯線下麵積分彆為41.935、82.734和0.676。其 ROC 麯線下麵積（AUC）比較經 Z 檢驗，綜閤檢查 F 分級評價診斷優于其他各項檢查的準確性（P ＜0.05），超聲與鉬靶X 線檢查診斷準確性比較差異無統計學意義（P ＞0.05）。結論乳腺超聲和鉬靶 X 線檢查是乳腺癌篩查的有效方法，而綜閤檢查分級評價方法能明顯提高乳腺癌的診斷能力。
목적：연구 ROC 곡선분석법평개유선림상검사、유선초성검사（US）、목파 X 선검사（MAM）급저3항검사종합분급재유선암사사중적진단개치，위농촌지구개전유선암사사선택괄의기술。방법채용문권조사화유선림상검사，대유선암고위인군채용유선초성화목파 X 선검사진행유선암사사，이용 ROC 곡선분석법평개림상검사、초성、목파 X 선검사급각항연합검사（종합검사）재유선암사사중적령민도화특이성。결과재23910명접수유선암사사적농촌부녀중，병리학진유선암31례，유선암검출솔위129.65/10만。유선종합검사적령민도、특이성급 ROC 곡선하면적분별위90.323、94.605화0.954；초성검사적령민도、특이성급 ROC 곡선하면적분별위70.968、90.288화0.814；목파 X 선검사적령민도、특이성급 ROC 곡선하면적분별위74.194、91.727화0.850；림상검사적령민도、특이성급 ROC 곡선하면적분별위41.935、82.734화0.676。기 ROC 곡선하면적（AUC）비교경 Z 검험，종합검사 F 분급평개진단우우기타각항검사적준학성（P ＜0.05），초성여목파X 선검사진단준학성비교차이무통계학의의（P ＞0.05）。결론유선초성화목파 X 선검사시유선암사사적유효방법，이종합검사분급평개방법능명현제고유선암적진단능력。
Objective To evaluate the values of different methods in breast cancer screening using receiver operating characteristic (ROC)curve analysis,and to suggest a appropriate model for female breast cancer screening in rural areas. Methods After questionnaire investigation and clinical examination,breast ultrasound and X -ray mammography were performed in the high risk group.Sensitivity and specificity of clinical examination, breast ultrasound, X -ray mammography and comprehensive examination were evaluated by ROC curves.Results There were 31 pathologically diagnosed cases among the 23,910 screening women.The detection rate of breast cancer was 129.65 /100,000.The sensitivity,specificity and the area under the ROC curves was 90.323,94.604 and 0.954 respectively for comprehensive examination,and 70.968,90.288 and 0.814 respectively for ultrasound examination,and 74.194,91.727 and 0.850 respectively for mammography examination,and 41.935,82.734 and 0.676 respectively for clinical examination.After Z test,comprehensive examination was better than other methods (P <0.05)and there was no significant difference between breast ultrasound and X -ray mammography (P >0.05).Conclusion Both ultrasound and X -ray mammography are the effective methods in breast cancer screening.The comprehensive examination could significantly improve the diagnostic capabilities of breast cancer.
