摘要
目的:研究S-Detect技术在乳腺肿块诊断中出现假阳性和假阴性结果的影响因素。方法:回顾并分析2019年5月—2022年3月南京医科大学第一附属医院613例女性患者的697个乳腺病灶,患者均进行了常规超声检查和S-Detect检查并取得手术后病理学检查结果。以病理学检查结果为标准,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估S-Detect诊断效能。将患者年龄、肿块最大径、形状、边缘、生长方向、钙化情况、后方回声、血流分级纳入分析,采用t检验或Mann-Whitney U检验比较假阴性与真阴性组、假阳性与真阳性组的连续变量,采用χ^(2)检验或Fisher精确概率检验比较分类变量,采用多因素二元logistic回归法分析独立影响因素。结果:患者的平均年龄为(47.1±13.6)岁,697个病灶中,良性病灶350个,恶性病灶347个,S-Detect诊断曲线下面积(area under curve,AUC)为0.835,Kappa值为0.670。患者年龄≥45岁(OR=2.898,P=0.002)、肿块边缘不光整(OR=4.778,P<0.001)、血流分级为2或3级(OR=2.447,P=0.009)与假阴性结果相关。患者年龄<45岁(OR=9.735,P<0.001)、肿块最大径<20 mm(OR=2.480,P=0.015)、肿块形状规则(OR=4.097,P=0.003)、边缘光整(OR=8.175,P<0.001)、血流分级为0或1级(OR=3.351,P=0.001)与假阳性结果显著相关。结论:当S-Detect诊断结果为良性时,患者年龄较大、肿块边缘不光整、血流分级较高是出现假阴性的影响因素。当S-Detect诊断结果为恶性时,患者较年轻、肿块较小、形状规则、边缘光整、血流分级较低是出现假阳性的影响因素。
Objective: To research the infuence factors of false positive results and false negative results of S-Detect in breast lesions diagnosis. Methods: 697 breast lesions of 613 patients in the First Affiliated Hospital of Nanjing Medical University from May 2019 to March 2022 were retrospectively analyzed. They all underwent preoperative breast ultrasound, S-Detect examination data and surgery for postoperative pathology. According to postoperative pathological, the diagnostic efficacy of S-Detect was evaluated. The age of patients, size, shape, margin, orientation, calciflcation, posterior feature and vascularity of lesions were included in the analysis. The t test and Mann-Whitney U rank sum test were used to compare the continuous variable of false negative and true negative group, false positive and true positive group. The χ^(2) test and Fisher exact test were used to compare the classifled variable.The logistic regression was used to analysis the signiflcant risk factors. Results: The mean age of the patients was(47.1±13.6)years. Among the 697 lesions, 350 were benign and 347 were malignant. The area under curve(AUC) of S-Detect was 0.835 and Kappa value was 0.670. Age 45 and over(OR=2.898, P=0.002), margin not circumscribed(OR=4.778, P<0.001), vascularity of 2 or 3 grade(OR=2.447, P=0.009) were significantly correlated with false negative results. The false positive results were signiflcantly associated with age under 45(OR=9.735, P<0.001), the maximum diameter less than 20 mm(OR=2.480, P=0.015),shape regular(OR=4.097, P=0.003), margin circumscribed(OR=8.175, P<0.001) and vascularity of 0 or 1 grade(OR=3.351,P=0.001). Conclusion: Among benign lesions diagnosed by S-Detect, the patients with older age, the lesions with not circumscribed margin and higher grade of vascularity are likely in the false negative group. In the malignant lesions diagnosed by S-Detect, the patients in the false positive group were younger in age, smaller in size, regular in shape, circumscribed in margin and lower grade of vascularity.
作者
潘加珍
刘心培
查海玲
杜丽雯
聂晨蕾
张曼琪
陈智慧
刘薇
杜宇
蔡梦君
栗翠英
PAN Jiazhen;LIU Xinpei;ZHA Hailing;DU Liwen;NIE Chenlei;ZHANG Manqi;CHEN Zhihui;LIU Wei;DU Yu;CAI Mengjun;LI Cuiying(Department of Ultrasound Diagnosis,First People’s Hospital,Nanjing Medical University,Nanjing 210000,Jiangsu Province,China)
出处
《肿瘤影像学》
2023年第1期64-72,共9页
Oncoradiology
