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目的探讨乳腺X线征象对乳腺良恶性病变诊断准确性的价值。资料与方法对105例乳腺癌与74例乳腺良性病变X线资料进行回顾性分析。制定X线摄影中钙化形态与软组织改变对良恶性病变的判断标准,从肯定恶性到肯定良性分为五类。由3位医师使用盲法进行诊断,对其诊断结果进行病例手术的金标准检验,计算其真阳性率、真阴性率,通过受试者工作特征(ROC)曲线观察其敏感性与特异性。结果 3位医师用所制定钙化与软组织X线表现的标准对良恶性病变诊断结果平均数为肯定恶性86例,误诊1例;可能恶性22例,误诊7例;不能肯定良恶性者22.3例,其中恶性3.3例,良性19例;可能良性11.3例,误诊1例;肯定良性36.3例,误诊0.3例。经统计学计算真阳性率为80%,真阴性率为99%。ROC曲线提示有较高的特异性和敏感性。结论乳腺X线显示的钙化与软组织病变表现的类型对良恶性病变诊断具有应用价值。在X线表现不能肯定时,应进一步检查,以避免对恶性肿瘤的漏诊。
Objective To investigate the value of mammography in the diagnosis of benign and malignant breast lesions. Materials and Methods Retrospective analysis of X-ray data of 105 cases of breast cancer and 74 cases of benign breast lesions. To develop radiographic calcifications and soft tissue changes in benign and malignant lesions to determine the criteria, from positive to positive benign can be divided into five categories. Blinded diagnosis was performed by 3 physicians and the gold standard of case operation was tested. The true positive rate and true negative rate were calculated, and their sensitivity and specificity were observed by receiver operating characteristic (ROC) curves. Results The average of the diagnostic results of benign and malignant lesions was determined by three physicians using the standard of calcification and soft tissue X-ray. 86 cases were diagnosed as malignant, 1 case was misdiagnosed, 22 cases could be malignant, 7 cases misdiagnosed, 22.3 cases could not be confirmed as benign and malignant, Among them, 3.3 were malignant, 19 were benign, 11.3 were probably benign, 1 were misdiagnosed, 36.3 were benign and 0.3 were misdiagnosed. According to the statistics, the true positive rate is 80% and the true negative rate is 99%. ROC curve suggests a higher specificity and sensitivity. Conclusion The types of calcifications and soft tissue lesions revealed by mammography are of value in the diagnosis of benign and malignant lesions. In the X-ray performance is not sure, further examination should be to avoid the misdiagnosis of malignant tumors.