中国生育健康杂志
中國生育健康雜誌
중국생육건강잡지
CHINESE JOURNAL OF REPRODUCTIVE HEALTH
2014年
3期
202-206
,共5页
乳腺癌筛查%高危因素%临床体检%超声检查%钼靶 X 线检查
乳腺癌篩查%高危因素%臨床體檢%超聲檢查%鉬靶 X 線檢查
유선암사사%고위인소%림상체검%초성검사%목파 X 선검사
Breast cancer screening%Clinical breast examination%Ultrasonography%Mammography
目的：评价临床体检（CBE）、超声检查（US）与乳腺钼靶 X 线检查（MAM）在乳腺癌筛查中的应用价值。方法选择参加 CBE、US 与 MAM筛查乳腺癌的35～59岁妇女，收集筛查个案记录，以病理组织学检查作为金标准，计算3种筛查方法单独与联合应用筛查乳腺癌的价值。结果共27991人纳入研究，病理组织学检查检出乳腺癌161例，患病率为575.2/10万。乳腺良性疾病11335例，患病率为40.5％。3种方法单独应用时， MAM的敏感度（72.0％）最高，CBE 的准确率（98.9％）、特异度（99.2％）和阳性预测值（24.2％）最高；2种方法联合应用时，US 联合 MAM敏感度（85.1％）最高，CBE 联合 MAM准确率（95.9％）、特异度（96.0％）和阳性预测值（10.4％）最高；所有不同筛查方法中 CBE、US 和 MAM联合的敏感度（90.1％）最高，特异度和阳性预测值最低，不同筛查方法的阴性预测值相当。结论在卫生资源有限的情况下，CBE 联合 US 应作为乳腺癌初筛，必要时进行MAM检查，可进一步提高筛查乳腺癌的敏感度。
目的：評價臨床體檢（CBE）、超聲檢查（US）與乳腺鉬靶 X 線檢查（MAM）在乳腺癌篩查中的應用價值。方法選擇參加 CBE、US 與 MAM篩查乳腺癌的35～59歲婦女，收集篩查箇案記錄，以病理組織學檢查作為金標準，計算3種篩查方法單獨與聯閤應用篩查乳腺癌的價值。結果共27991人納入研究，病理組織學檢查檢齣乳腺癌161例，患病率為575.2/10萬。乳腺良性疾病11335例，患病率為40.5％。3種方法單獨應用時， MAM的敏感度（72.0％）最高，CBE 的準確率（98.9％）、特異度（99.2％）和暘性預測值（24.2％）最高；2種方法聯閤應用時，US 聯閤 MAM敏感度（85.1％）最高，CBE 聯閤 MAM準確率（95.9％）、特異度（96.0％）和暘性預測值（10.4％）最高；所有不同篩查方法中 CBE、US 和 MAM聯閤的敏感度（90.1％）最高，特異度和暘性預測值最低，不同篩查方法的陰性預測值相噹。結論在衛生資源有限的情況下，CBE 聯閤 US 應作為乳腺癌初篩，必要時進行MAM檢查，可進一步提高篩查乳腺癌的敏感度。
목적：평개림상체검（CBE）、초성검사（US）여유선목파 X 선검사（MAM）재유선암사사중적응용개치。방법선택삼가 CBE、US 여 MAM사사유선암적35～59세부녀，수집사사개안기록，이병리조직학검사작위금표준，계산3충사사방법단독여연합응용사사유선암적개치。결과공27991인납입연구，병리조직학검사검출유선암161례，환병솔위575.2/10만。유선량성질병11335례，환병솔위40.5％。3충방법단독응용시， MAM적민감도（72.0％）최고，CBE 적준학솔（98.9％）、특이도（99.2％）화양성예측치（24.2％）최고；2충방법연합응용시，US 연합 MAM민감도（85.1％）최고，CBE 연합 MAM준학솔（95.9％）、특이도（96.0％）화양성예측치（10.4％）최고；소유불동사사방법중 CBE、US 화 MAM연합적민감도（90.1％）최고，특이도화양성예측치최저，불동사사방법적음성예측치상당。결론재위생자원유한적정황하，CBE 연합 US 응작위유선암초사，필요시진행MAM검사，가진일보제고사사유선암적민감도。
Objective We aimed to determine which combination of clinical breast examination (CBE ), ultrasonography (US),and mammography (MAM)would optimize breast cancer detection. Methods We conducted a trial of screening with CBE,US,and MAM among women aged 35-59 years old.Demographic information and medical records were collected.Using the results of biopsies as the gold standard,the performances of the three screening methods used alone or in parallel were compared. Results Among the 27 991 eligible women,161 with breast cancer (575.2 /100 000)and 11335 with benign diseases (40.5%)were identified.When each of the three screening methods was used individually,the highest sensitivity was achieved by MAM(72.0%),and the highest accuracy rate (98.9%),specificity (99.2%)and positive predictive value (24.2%)were achieved by CBE.When two of the tree screening methods were used in combination,the highest sensitivity was achieved by paralleling US with MAM(85.1%),and the highest accuracy rate (95.9%),specificity (96.0%)and positive predictive value (10.4%)were achieved by paralleling CBE with MAM.Among all the screening methods,the highest sensitivity (90.1%)and the lowest specificity and positive predictive value were achieved by paralleling CBE,with US and MAM,and no significant difference in negative predictive value was observed. Conclusion When limited health resources were taken into consideration,a strategy of screening with CBE and US at the first stage,followed by MAMwhen indicated,may optimize breast cancer detection.
