彩色多普勒超声特征对乳腺无症状炎性改变和浸润性导管癌的鉴别诊断价值

doi:10.20047/j.issn1673-7210.2023.28.36

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摘要目的分析彩色多普勒超声特征对乳腺无症状炎性改变和浸润性导管癌的鉴别诊断价值。方法选择南京医科大学附属无锡妇幼保健院2019年1月至2021年12月收治的病理诊断并确认的无症状炎性改变患者为炎症组（41例），浸润性导管癌患者为肿瘤组（91例）。采用彩色多普勒超声诊断仪对患者病灶大小、形态、生长方位、回声情况、钙化情况进行探查；利用Adler半定量法评估患者血流信号，测量病灶的血流阻力指数（RI）和峰值流速（PSV）；彩色多普勒超声特征诊断浸润性导管癌的模型方程采用logistic回归分析；绘制受试者操作特征曲线，评估彩色多普勒超声特征对浸润性导管癌的诊断价值。结果两组病灶形状、边缘状态、内部回声比较，差异无统计学意义（P＞0.05）；两组病灶生长方位、后方回声、钙化、Adler分级、RI及PSV比较，差异有统计学意义（P＜0.05）。彩色多普勒超声特征诊断浸润性导管癌的方程为Log（P）=0.654×生长方位+0.619×后方回声+ 0.702×钙化+0.718×Adler分级+0.707×RI+0.668×PSV。彩色多普勒超声特征模型诊断浸润性导管癌的曲线下面积为0.894（95%CI：0.848~0.941），灵敏度为89.10%，特异度为76.80%。结论采用基于彩色多普勒超声特征构建的logistic回归模型在对乳腺无症状炎性改变和浸润性导管癌具有较高的鉴别诊断价值。

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	亓琳1 张欢欢1　　沈自芳1▲　　杨蕊2

关键词 ：彩色多普勒超声特征, Logistic回归模型, 乳腺无症状炎性改变, 浸润性导管癌

Abstract：Objective To analyze the value of color Doppler ultrasound features in differential diagnosis of breast asymptomatic inflammatory changes and invasive ductal carcinoma. Methods Patients with asymptomatic inflammatory changes diagnosed and confirmed by pathology who admitted to Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University from January 2019 to December 2021 were selected as inflammation group (41 cases), and invasive ductal carcinoma patients as tumor group (91 cases). The size, shape, growth orientation, echo, and calcification of the lesions were investigated by color Doppler ultrasonography; Adler semi-quantitative method was used to evaluate the blood flow signal, and the blood flow resistance index (RI) and peak systolic velocity (PSV) were measured; the model equation of color Doppler ultrasonography in diagnosis of invasive ductal carcinoma was analyzed by logistic regression; the receiver operation characteristic curve was drew, the diagnostic value of color Doppler ultrasonography in invasive ductal carcinoma was evaluated. Results There were no significant differences in lesion shape, edge state, and internal echo between two groups (P＞0.05); there were significant differences in growth orientation, posterior echo, calcification, Adler grade, RI, and PSV between two groups (P＜0.05). The equation for diagnosing invasive ductal carcinoma with color Doppler ultrasound features was Log (P) = 0.654× growth orientation +0.619× posterior echo +0.702× calcification +0.718×Adler grade +0.707×RI+0.668×PSV. The area under the curve of the color Doppler ultrasound characteristic model for diagnosing invasive ductal carcinoma were 0.894 (95%CI: 0.848-0.941), sensitivity was 89.10%, and specificity was 76.80%. Conclusion The logistic regression model based on color Doppler ultrasound features has a high value in the differential diagnosis of breast asymptomatic inflammatory changes and invasive ductal carcinoma.

Key words： Color Doppler ultrasound features Logistic regression model Breast asymptomatic inflammatory changes Invasive ductal carcinoma

基金资助:江苏省卫生健康委员会科研项目（M2022105）。

通讯作者: ▲通讯作者

引用本文:

亓琳1 张欢欢1　　沈自芳1▲　　杨蕊2. 彩色多普勒超声特征对乳腺无症状炎性改变和浸润性导管癌的鉴别诊断价值[J]. 中国医药导报, 2023, 20(28): 164-167.
QI Lin1 ZHANG Huanhuan1 SHEN Zifang1▲ YANG Rui2. Value of color Doppler ultrasound features in differential diagnosis of br-east asymptomatic inflammatory changes and invasive ductal carcinoma. 中国医药导报, 2023, 20(28): 164-167.

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