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目的探讨乳腺彩超和乳腺钼靶对社区不同年龄和病灶大小的乳腺癌患者筛查价值。方法对本市5个社区30岁及以上女性进行乳腺癌筛查。首先行乳腺彩超筛查,对可疑者再行乳腺钼靶检查,最终经手术病理证实乳腺病灶316例。其中良性病变182例,乳腺癌134例。将乳腺彩超、乳腺钼靶、两者联合检查与手术病理结局进行对照,评价其对不同大小病灶和年龄的乳腺癌患者诊断敏感度和特异性。结果根据超声检查测出的乳腺病灶长轴分为3组:A组(病灶长轴≤1 cm)62个,B组(病灶长轴1.1~2 cm)156个,C组(病灶长轴≥2.1 cm)98个。乳腺彩超对B组和C组诊断敏感度高于A组,差异有统计学意义(P<0.05);但在诊断特异性方面差异无统计学意义(P>0.05);A组乳腺钼靶检测敏感度高于乳腺彩超,差异有统计学意义(P<0.05);B组、C组联合检查的敏感度和特异性均高于乳腺钼靶、乳腺彩超,差异有统计学意义(P<0.05)。根据年龄分为2组:30~50岁组病灶206个,>50岁组病灶110个。30~50岁患者两者联合检查敏感度高于乳腺钼靶,但特异性降低,差异有统计学意义(P<0.05);>50岁患者乳腺钼靶特异性高于乳腺彩超和两者联合检查,差异有统计学意义(P<0.05);乳腺彩超对不同年龄组患者诊断敏感度和特异性差异无统计学意义(P>0.05);>50岁患者乳腺钼靶检测敏感度和特异性均高于30~50岁,差异有统计学意义(P<0.05)。结论乳腺钼靶诊断乳腺癌敏感度与年龄有关,而超声与年龄无关;乳腺钼靶与超声诊断敏感度和特异性均与病灶大小有关;两者联合检查可提升对不同病灶大小和不同年龄乳腺癌患者诊断的敏感度和特异性。
Objective To investigate the screening value of breast ultrasound and breast mammography in breast cancer patients of different age and size in community. Methods Breast cancer screening was performed on women aged 30 and over in 5 communities in this city. First line of breast color Doppler ultrasound screening of suspicious mammography again, and ultimately confirmed by surgical pathology of breast lesions in 316 cases. 182 cases of benign lesions, 134 cases of breast cancer. The breast ultrasonography, breast molybdenum target, the two combined examination and surgical pathological outcomes were compared to evaluate the different size lesions and age of breast cancer patients with sensitivity and specificity. Results According to the long axis of breast lesions detected by ultrasonography, there were 3 groups: 62 in group A (long axis≤1 cm), 156 in group B (long axis 1.1 ~ 2 cm), group C 2.1 cm) 98. The sensitivity of breast color Doppler ultrasound in group B and group C was higher than that in group A (P <0.05), but there was no significant difference in diagnostic specificity (P> 0.05) (P <0.05). The sensitivity and specificity of combined examination in group B and group C were higher than that in breast mammography and mammography (P <0.05), and the difference was statistically significant ). Divided into two groups according to age: 206 in the 30-50 age group and 110 in the> 50 age group. The joint detection sensitivity between the two groups was higher than that of breast mammography, but the specificity was lower, the difference was statistically significant (P <0.05). The mammographic specificity of mammography in patients> 50 years old was higher than that of mammography (P <0.05). There was no significant difference in the diagnostic sensitivity and specificity between the two groups (P> 0.05). The sensitivity and specificity of mammography in> 50 years Higher than 30 to 50 years old, the difference was statistically significant (P <0.05). Conclusion The sensitivity of breast mammography in diagnosis of breast cancer is related to age, but the ultrasound has no relationship with age. The sensitivity and specificity of breast mammography and ultrasound diagnosis are related to the size of the lesion. The combination of the two can improve the sensitivity of breast lesions of different sizes and ages Sensitivity and specificity of cancer diagnosis.