CAJ | 학술논문

目的比较乳腺X线和超声检查对T1及Tis期乳腺癌的诊断效能,为探索适合中国北方女性乳腺癌筛查模式提供循证医学信息.方法收集2011年7月至2013年7月就诊于天津市肿瘤医院具备完整的乳腺X线及超声检查资料T1及Tis期乳腺癌患者1 630例,采用x2检验比较两种影像学方法对乳腺癌的检出率和诊断准确率.结果 1 630例患者共1 665个病变,乳腺X线和超声检查均检出的病变共1 559个.在病变检出率方面,对于脂肪型或少量纤维腺体型乳腺,X线检查对病变检出率明显高于超声检查(P＜0.05);对于多量纤维腺体型乳腺,两者对病变检出率差异无统计学意义;对于致密型乳腺,超声检查对病变检出率则明显高于X线检查(P＜0.05).在病变诊断准确率方面,对于脂肪型及少量纤维腺体型乳腺,本组资料显示超声检查对病变的诊断准确率相同或低于X线;对于多量纤维腺体和致密型乳腺,超声检查对病变的诊断准确率高于X线检查,但各组间比较差异均无统计学意义(均P＞0.05).另外,基于X线检查将病变类型分为肿块型和非肿块型病变,随着纤维腺体密度升高,非肿块型病变所占比例升高,肿块型病变比例降低.结论乳腺X线检查对于纤维腺体量较少的T1及Tis期乳腺癌的病变检出率及诊断准确率较高,而超声检查对于纤维腺体量较多的T1及Tis期乳腺癌的病变检出率及诊断准确率较高.基于X线的病变类型进行分组,病变类型与纤维腺体类型之间存在一定的相关性.
목적 비교유선X선화초성검사대T1급Tis기유선암적진단효능,위탐색괄합중국북방녀성유선암사사모식제공순증의학신식.방법 수집2011년7월지2013년7월취진우천진시종류의원구비완정적유선X선급초성검사자료T1급Tis기유선암환자1 630례,채용x2검험비교량충영상학방법대유선암적검출솔화진단준학솔.결과 1 630례환자공1 665개병변,유선X선화초성검사균검출적병변공1 559개.재병변검출솔방면,대우지방형혹소량섬유선체형유선,X선검사대병변검출솔명현고우초성검사(P＜0.05);대우다량섬유선체형유선,량자대병변검출솔차이무통계학의의;대우치밀형유선,초성검사대병변검출솔칙명현고우X선검사(P＜0.05).재병변진단준학솔방면,대우지방형급소량섬유선체형유선,본조자료현시초성검사대병변적진단준학솔상동혹저우X선;대우다량섬유선체화치밀형유선,초성검사대병변적진단준학솔고우X선검사,단각조간비교차이균무통계학의의(균P＞0.05).령외,기우X선검사장병변류형분위종괴형화비종괴형병변,수착섬유선체밀도승고,비종괴형병변소점비례승고,종괴형병변비례강저.결론 유선X선검사대우섬유선체량교소적T1급Tis기유선암적병변검출솔급진단준학솔교고,이초성검사대우섬유선체량교다적T1급Tis기유선암적병변검출솔급진단준학솔교고.기우X선적병변류형진행분조,병변류형여섬유선체류형지간존재일정적상관성.
Objective To compare the efficacy of mammography versus ultrasonography in detecting stages T1 and Tis breast cancer.Methods Mammography and ultrasonograhpy data were collected for 1 630 stages T1 and Tis breast cancer from July 2011 to July 2013.Chi-square test was used to analyze the detection rate and diagnostic rate of two methods.Results Among 1 630 patients with 1 665 focus,1 559 focus were detected by both methods.In term of detection rate,mammography had a higher rate in mostly fatty and scattered fibroglandular breast while ultrasonography offered advantages in extremely dense breast.And statistical significance existed among these groups (P ＜ 0.05).In heterogeneously dense group,the detection rate of two methods had no statistical significance (P ＞ 0.05).In term of diagnostic rate,mammography had a higher diagnostic rate in mostly fatty and scattered fibroglandular breast.On the contrary,ultrasonography was superior to mammography in heterogeneously and extremely dense breast.No statistical significance existed among these groups (P ＞ 0.05).Furthermore the focus were classified into mass and non-mass types based on mammographic images.As the volume of fibroglandular tissue increased,the amount of mass type focus increased while that of non-mass type focus decreased.Conclusion For stages T1 and Tis breast cancer,mammography has higher detection and diagnostic rates in mostly fatty and scattered fibroglandular breast while ultrasonography is better for heterogeneously and extremely dense breast.There are some correlations between fibroglandular and focus types based on mammographic images.