触诊、B超和钼靶检查判断浸润性乳腺癌原发病灶准确性研究Study on the accuracy of physical examination,ultrasonography and mammography on diagnosing primary tumor of invasive breast cancer
单美慧,冷晓玲,姚雪梅,马斌林,王薇,郑玉梅
摘要(Abstract)：
目的评价临床检查中触诊、B超和钼靶检查判断浸润性乳腺癌原发病灶的准确性。方法回顾性分析2005年3月1日—2008年9月1日新疆医科大学附属肿瘤医院收治的545例经手术证实为浸润性乳腺癌的女性患者的临床检查和病理资料。记录原发肿瘤和腋窝淋巴结触诊、B超、钼靶检查结果,并与病理结果进行对照分析。结果 545例患者触诊和病理资料完整,其中522例接受了B超检查,516例接受了钼靶检查。触诊的准确率为59.1%(322/545),B超的准确率为84.9%(443/522),钼靶的准确率为69.8%(360/516),三者差异有统计学意义(P=0.000)。在评价原发肿瘤大小方面,触诊和B超一致(均为T1、T2、T3或T4)的几率为68.0%(355/522),触诊和钼靶一致的几率为35.1%(181/516),B超和钼靶一致的几率为37.4%(185/495),而三者均一致的几率为32.9%(163/495),4组间差异有统计学意义(P=0.000)。在判断腋窝淋巴结状况方面,触诊、B超和钼靶与病理结果均有统计学差异(P值均为0.000),三者与病理结果的一致性检验Kappa值分别为0.164、0.401和0.171(P值均为0.000),灵敏度分别为25%、63%和31%,特异度分别为93%、78%和87%。结论 B超判断浸润性乳腺癌患者乳腺原发肿瘤的准确性最高。触诊、B超和钼靶判断原发肿瘤大小差异较大,其中B超和触诊结果一致的可能性最大。触诊、B超和钼靶判断腋窝淋巴结状况的准确性均不高。
关键词(KeyWords)： 触诊;B超;钼靶;浸润性乳腺癌
基金项目(Foundation): 国家自然科学基金(30960376)
作者(Author): 单美慧,冷晓玲,姚雪梅,马斌林,王薇,郑玉梅
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