摘要
目的探讨超声引导下穿刺活检(ultrasound-guided core needle biopsy,US-CNB)对乳腺病变超声诊断图像的影像报告与数据系统(breast imaging reporting and data system,BI-RADS)分级弹性校正4B类结节在乳腺癌定性诊断中的临床应用价值。方法选取2014年9月至2016年9月93例就诊于本院且经乳腺超声常规检查后弹性校正分级为BI-RADS 4B类结节的患者,测算评估后行US-CNB,以术后病理结果为金标准,分析其诊断特异度、灵敏度、准确率、假阴性率,并比较其与术后病理诊断结果的符合率。结果 93例患者US-CNB的结果中55例为乳腺癌,38例为良性肿物,术后病理结果中58例为乳腺癌,35例为良性肿物。55例US-CNB结果为乳腺癌者与术后病理一致,38例US-CNB结果为良性结节者中3例术前US-CNB分别报告为硬化性腺病与纤维腺瘤而术后病理类型为浸润性导管癌、浸润性乳头癌和化生性癌。US-CNB诊断乳腺癌的特异度为100%,灵敏度为94.82%,准确率为96.77%,假阴性率为5.17%。结论 US-CNB联合BI-RADS分级弹性校正对乳腺4B类单发结节的诊断特异度、灵敏度及准确率较高,作为一种精准的诊疗技术为临床制定后续治疗方案以及预后判断提供了准确的病理依据与重要信息。
Objective To evaluate the clinical value of ultrasound-guided core-needle biopsy （US-CNB） in the diagnosis of breast mass for category 4B of a validation study of 93 cases in the second edition of the breast imaging reporting and data system （BI-RADS）. Method The pathological characteristics of 93 patients with breast masses who undergone ultrasound elastography strain ratio correction （ESR） and US-CNB in department of ultrasonography of our hospital from September 2014 to September 2016 were retrospectively analyzed. Each patient was evaluated with postoperative pathological as the gold standard. Result In a series screening of the ESR and US-CNB of the 93 patients, 55 cases were diagnosed with breast cancer and 38 cases of benign masses. Finally, 58 cases were confirmed with breast cancer and 35 cases of benign lesions according to postoperative pathological. As we demonstrated here, The final research findings show that 55 cases of US-CNB were consistent with the consequences of postoperative pathological with breast cancer. However, 3 cases of the 38 patients reported with benign lesions of US-CNB, which in a type of sclerosing adenosis and fibroadenomas were confirmed to breast carcinoma of postoperative pathological with the Invasive ductal carcinoma, invasive papillary carcinoma and metaplastic carcinoma. The clinical validation value of specificity of the US-CNB in the diagnosis of breast carcinoma for category 4B was 100%, Simultaneously, in the aspect of sensibilities, accuracies and false-negative rate for category 4B reach to 94.82%, 96.77% and 5.17%, respectively. Conclusion The clinical validation value of the US-CNB in the diagnosis of breast carcinoma for category 4B in the aspect of specificity, sensibility and accuracy is worthy of affirmation and significant difference. As an accurate diagnosis and treatment technology, US-CNB provides accurate pathological basis and important information for clinical follow-up treatment and prognosis.
作者
韩洋
向维
李亚洲
孟凡荣
HAN Yang;XIANG Wei;LI Ya-zhou;MENG Fan-rong(Department of Ultrasonography, Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangsu Nanjing 210014, China)
出处
《中国医刊》
CAS
2018年第5期543-546,共4页
Chinese Journal of Medicine
基金
江苏省南京市医学科技发展项目(YKK14164)
关键词
乳腺癌
结节
穿刺活检
弹性成像
Breast cancer
Mass
Biospy
Elasticity imaging
