CAJ | 학술논문

目的探讨乳腺X线、超声两种筛查方法对社区女性乳腺癌检出的价值.方法 8234名社区妇女参加乳腺影像初次筛查,包括乳腺X线检查(8232名)以及超声检查(8231名),分析影像筛查的召回率、活检率、癌检出率,采用行×列卡方检验或Fisher精确检验比较乳腺X线摄影、超声以及两种方法对乳腺癌检出的敏感度.结果 256名妇女被召回,召回率3.11％(256/8234),其中117名分别行穿刺活检(42名)或手术(75名),活检率1.42％(117/8234).X线结合超声共检出乳腺癌33例,癌检出率0.40％(33/8234),筛查癌中早期癌比例为51.5％(17/33),另发现间隙期癌3例,筛查癌占初筛人群0.44％(36/8234).X线结合超声检出乳腺癌的敏感度91.7％(33/36),乳腺X线检出乳腺癌31例,敏感度86.1％(31/36),乳腺超声检出乳腺癌20例,敏感度55.6％(20/36),X线加超声及单用乳腺X线较乳腺超声能筛查出更多的乳腺癌患者,敏感度的差异有统计学意义(x2值分别为12.0834、8.1345,P值均＜0.01).乳腺X线摄影检出乳腺癌的阳性预测值为10.43％(31/297).结论乳腺X线摄影较超声能筛查出更多的乳腺癌,两种影像筛查方法组合可能更适合我国城市社区妇女乳腺癌筛查.
목적 탐토유선X선、초성량충사사방법대사구녀성유선암검출적개치.방법 8234명사구부녀삼가유선영상초차사사,포괄유선X선검사(8232명)이급초성검사(8231명),분석영상사사적소회솔、활검솔、암검출솔,채용행×렬잡방검험혹Fisher정학검험비교유선X선섭영、초성이급량충방법대유선암검출적민감도.결과 256명부녀피소회,소회솔3.11％(256/8234),기중117명분별행천자활검(42명)혹수술(75명),활검솔1.42％(117/8234).X선결합초성공검출유선암33례,암검출솔0.40％(33/8234),사사암중조기암비례위51.5％(17/33),령발현간극기암3례,사사암점초사인군0.44％(36/8234).X선결합초성검출유선암적민감도91.7％(33/36),유선X선검출유선암31례,민감도86.1％(31/36),유선초성검출유선암20례,민감도55.6％(20/36),X선가초성급단용유선X선교유선초성능사사출경다적유선암환자,민감도적차이유통계학의의(x2치분별위12.0834、8.1345,P치균＜0.01).유선X선섭영검출유선암적양성예측치위10.43％(31/297).결론 유선X선섭영교초성능사사출경다적유선암,량충영상사사방법조합가능경괄합아국성시사구부녀유선암사사.
Objective To discuss the significance of two screening methods (mammography and ultrasonography) for detection of breast cancer in Chinese urban community.Methods The first round imaging screening of breast cancer were performed in 8234 women in shanghai community.The screening methods include mammography (8232 patients) and ultrasonography (8231 patients).The rate of recall,biopsy,cancer detection of the imaging screening were analyzed.Sensitivity of three methods (mammography,ultrasonography,mammography with ultrasonography) were compared.Chi-square test or Fisher exact test were used for the statistical analysis.Results Two hundred and fifty six women were recalled in the screening,and the recall rates were 3.11％ (256/8234).One hundred and seventeen of 256 women underwent biopsy,and the biopsy rates were 1.42％ (117/8234).Thirty three breast cancers were detected by mammography with ultrasonography,and the cancer detection rate were 0.40％ (33/8234).Seventeen of 33 patients had early stage breast cancer (51.5％,17/33).In addition,3 interval cancers were found at screening.Thirty one breast cancers were detected by mammography and only 20 of them were detected by uhrasonography.The sensitivity of three methods (mammography,ultrasonography,mammography with ultrasonography) for detecting breast cancer were 91.7％ (33/36),86.1％ (31/36) and 55.6％ (20/36)respectively.There were statistical differences of sensitivity among three screening methods.Mammography with ultrasonography and mammography only can detect more breast cancer than ultrasonography (x2 =12.0834,8.1345 ;P ＜ 0.01).PPV1 of mammography were 10.43％ (31/297).Conclusion Although mammography can detect more breast cancer than ultrasonography,combination of two kinds of screeningmethods may be more suitable for screening for breast cancer in women in Chinese urban communities.