| 摘要: |
| 摘要
目的 对比研究＜2 cm的三阴性乳腺癌（Triple negative breast cancer，TNBC）与乳腺纤维腺瘤（fibroadenoma,FA）的超声声像图特征及几何圆度，以提高对＜2 cm TNBC的诊断准确性。
方法 回顾性分析2015年1月-2019年12月于南京医科大学附属无锡人民医院接受手术治疗并经病理证实的74例＜2 cm的TNBC（TNBC组）和125例FA（FA组）患者的超声声像图，计算肿块的几何圆度, 比较二组年龄、病灶大小、形态、方位、边缘、回声模式、后方回声特征、钙化等特征及几何圆度。
结果 TNBC组的平均年龄为（47.3±10.7）岁，FA组为（35.5±9.0）岁，差异有统计学意义（P＜0.05）。与FA组相比，TNBC组出现不规则形（66.2%，49/74）、方位不平行（18.9％，14/74）、边缘不光整（87.8%，65/74）、后方回声增强（64.9%，48/74）的几率更高，其差异有统计学意义(P<0.05)。且TNBC组中更多数肿块被归类为BI-RADS 4类和5类，与FA组比较差异有统计学意义(P<0.05)。TNBC组的平均几何圆度（81%±9%）大于FA组（66％±11％），差异有统计学意义(P<0.05)，ROC曲线显示鉴别诊断二组的几何圆度的最佳截断值为80%，AUC为0.816，敏感性、特异性为77.2%、74.6%。多因素分析显示，患者年龄大、形态不规则、方位不平行、后方回声增强、BI-RADS分类为 4类和5类，以及病灶几何圆度更大是＜2 cm的TNBC的独立影响因素。
结论 与FA相比，＜2 cm的TNBC患者年纪偏大，往往表现出更多可疑的超声特征和更大的几何圆度。这些特征可能有助于区分＜2 cm的TNBC和纤维腺瘤。 |
| 关键词: 超声 几何圆度 三阴性乳腺癌 纤维腺瘤 |
| DOI： |
| 投稿时间：2020-05-17修订日期：2020-06-08 |
| 基金项目: |
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| Ultrasound features and geometric roundness in differential diagnosis between triple negative breast cancer smaller than 2 cm and fibroadenoma |
| dingyan |
| () |
| Abstract: |
| Abstract
Objectives To compare the ultrasound features and geometric roundness of triple negative breast cancer (TNBC) smaller than 2 cm and fibroadenoma9(FA), and to improve the diagnostic accuracy of TNBC smaller than 2 cm.
Methods From January 2015 to December 2019, 74 patients underwent surgical treatment with pathologically confirmed TNBC smaller than 2 cm (TNBC group) and 125 FA (FA group) patients at the affiliated Wuxi People''s Hospital of Nanjing Medical University were included in this retrospective analysis. We evaluated the ultrasonotomograms from all patients and calculating the geometric roundness of the mass. The age, lesion size, shape, orientation, margin, echo pattern, posterior echo characteristics, calcification and other characteristics and geometric roundness of the two groups were compared.
Results There was a significant difference in the average age between TNBC group and FA group(47.3 ± 10.7 vs. 35.5 ± 9.0, P<0.05). Compared with the FA group, the probabilities of irregular shape (66.2%, 49/74), non-parallel orientation (18.9%, 14/74), irregular margin (87.8%, 65/74), and rear echo enhancement (64.9 %, 48/74) were higher in TNBC group (P<0.05). Moreover, more masses in the TNBC group were classified as BI-RADS 4 and 5 categories, which was statistically different from the FA group (P <0.05). The average geometric roundness of the TNBC group (81% ± 9%) was significant greater than that of the FA group (66% ± 11%) (P <0.05). ROC curve analysis showed that the best cutoff value in differential diagnosis of these two groups was 80%, with the area under ROC curve (AUC) value of 0.816. The sensitivity and specificity were 77.2% and 74.6%, respectively. Multivariate analysis showed that advanced patient age, irregular shape, non-parallel orientation, posterior echo enhancement, BI-RADS classification into categories 4 and 5, and greater geometrical roundness of the lesion were independent influencing factors for TNBC smaller than 2 cm.
Conclusions Compared with FA, advanced aged patients with TNBC smaller than 2 cm often show more suspicious ultrasound features and greater geometric roundness. These features may help to distinguish TNBC smaller than 2 cm and fibroadenoma. |
| Key words: Ultrasound, geometric roundness, triple negative breast cancer, fibroadenoma |
