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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2016, Vol. 13 ›› Issue (01) : 17 -20. doi: 10.3877/cma.j.issn.1672-6448.2016.01.006

所属专题： 乳腺超声； 文献；

浅表器官超声影像学

热层析成像联合高频超声对T1期乳腺癌的诊断价值
何玉霜1, 彭玉兰1,†(), 金亚1, 赵海娜1, 骆洪浩1   
  1. 1. 610041　成都，四川大学华西医院超声科
  • 收稿日期:2015-11-30 出版日期:2016-01-01
  • 通信作者: 彭玉兰
  • 基金资助:
    国家科技部重大科学仪器设备开发专项(2012YQ16020305)

Breast thermal tomography and high frequency ultrasound imaging in predicting small breast cancer

Yushuang He1, Yulan Peng1,†(), Ya Jin1, Haina Zhao1, Honghao Luo1   

  1. 1. Department of Ultrasonography, West China of Sichuan University, Chendu 610041, China
  • Received:2015-11-30 Published:2016-01-01
  • Corresponding author: Yulan Peng
  • About author:
    Corresponding author: Peng Yulan, Email:
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何玉霜, 彭玉兰, 金亚, 赵海娜, 骆洪浩. 热层析成像联合高频超声对T1期乳腺癌的诊断价值[J]. 中华医学超声杂志（电子版）, 2016, 13(01): 17-20.

Yushuang He, Yulan Peng, Ya Jin, Haina Zhao, Honghao Luo. Breast thermal tomography and high frequency ultrasound imaging in predicting small breast cancer[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(01): 17-20.

目的

探讨热层析成像、高频超声及联合诊断对T1期乳腺癌的诊断效能。

方法

回顾性分析2013年5月至12月在四川大学华西医院行超声检查且经病理证实的163例乳腺肿瘤（最大直径≤2 cm）患者的病例资料，采用热层析成像技术联合超声诊断技术对病灶进行定性诊断。以病理学诊断为金标准，计算热层析成像、高频超声及联合诊断的敏感度、特异度及准确性；绘制这3种检查方法的受试者操作特性（ROC）曲线。

结果

高频超声检查、热层析成像及联合诊断T1期乳腺癌患者的OR值分别为11.070、9.091、13.345，单一高频超声检查、热层析成像及两者联合诊断对T1期乳腺癌患者均有较好的筛查作用（P值均<0.01）。高频超声检查、热层析成像及两者联合诊断T1期乳腺癌患者的敏感度分别为96.77%、64.52%、64.52%，特异度分别为62.12%、83.33%、89.39%，准确性分别为68.71%、79.75%、84.66%。高频超声、热层析成像及两者联合诊断T1期乳腺癌患者ROC曲线下面积为0.762、0.739、0.753。

结论

热层析成像联合高频超声检查可提高诊断直径≤2 cm的T1期乳腺癌患者的特异度和准确性，减少假阳性病例。

关键词: 乳腺肿瘤, 热层析成像, 超声检查
Objective

To investigate the clinical value of breast thermal tomography combined with high frequency ultrasound imaging in the diagnosis of small breast cancer.

Methods

This retrospective study analyzed 163 breast tumors (≤2 cm) which were examined by high frequency ultrasound imaging during May to December, 2013 and the thermal tomography combined with ultrasound were used for the diagnosis. According to the pathology results, the sensitivity, specificity and accuracy of thermal tomography, high frequency ultrasound and the combined method were calculated. The odds ratio of the three methods were claculated by Chi-square test in the diagnosis of T1breast cancer and the difference of sensitivity, specificity and accuracy were compared. The receiver operating characteristic curve was drawn.

Results

The odds ratio of high frequency ultrasound, thermal tomography and the combined method in the diagnosis of T1breast cancer were 11.070, 9.090 and 13.345, and there was statistical significance (P<0.05) for each of them. The sensitivity, specificity and accuracy of ultrasound in the diagnosis of T1breast cancer were 96.77%, 62.12% and 68.71%. The sensitivity, specificity and accuracy of thermal tomography in the diagnosis of T1breast cancer were 64.52%, 83.33% and 79.75%. The sensitivity, specificity and accuracy of combined method were 64.52%, 89.39% and 84.66%. The area under curve (AUC) of thermal tomography, high frequency ultrasound and the combined method were 0.739, 0.762 and 0.753.

Conclusion

Specificity and accuracy of thermal tomography combined with high-frequency ultrasound has been greatly improved in the diagnosis of T1breast cancer.

Key words: Breast neoplasms, Thermal tomography, Ultrasonography
图1 乳腺恶性肿瘤热层析成像示意图（图a）及典型诊断曲线（图b）
表1 热层析成像、高频超声检查及其联合诊断乳腺肿瘤与病理学结果的比较（个）
诊断方法 病理结果 合计
恶性 良性
热层析成像 ? ? ?
? 恶性 20 22 42
? 良性 11 110 121
高频超声 ? ? ?
? 恶性 27 50 77
? 良性 4 82 86
联合诊断 ? ? ?
? 恶性 19 12 31
? 良性 14 118 132
表2 热层析成像、高频超声检查及其联合诊断T1期乳腺癌的诊断效能（%）
诊断方法 敏感度 特异度 准确性
超声诊断 96.77 62.12 68.71
热层析诊断 64.52 83.33 79.75
联合诊断 64.52 89.39 84.66
图2 热层析成像、超声检查以及两者联合诊断T1期乳腺癌的ROC曲线
[1]
Forouzanfar MH, Foreman KJ, Delossantos AM, et al. Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis [J].Lancet, 2011, 378 (9801): 1461-1484.
[2]
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015 [J]. CA Cancer J Clin, 2015, 65 (1): 5-29.
[3]
Gradishar WJ, Anderson BO, Balassanian R, et al. Breast cancer version 2.2015 [J]. J Natl Compr Canc Netw, 2015, 13 (4): 448-475.
[4]
Robson M, Offit K. Clinical practice. Management of an inherited predisposition to breast cancer [J]. N Engl J Med, 2007, 357 (2): 154-162.
[5]
Metcalfe KA, Birenbaum-Carmeli D, Lubinski J, et al. International variationin rates of uptake of preventive options in BRCA1 and BRCA2 mutation carriers [J]. Int J Cancer, 2008, 122 (9): 2017-2022
[6]
Sardanelli F, Podo F. Breast imaging in women at high-risk of breast cancer. Is something changing in early breast cancer detection? [J]. Eur Radiol, 2007, 17 (4): 873-887.
[7]
Michel AP, Liakat S, Bors K, et al. In vivo measurement of mid-infrared light scattering from human skin [J]. Biomed Opt Express, 2013, 4 (4): 520-530.
[8]
Chen H, Wang H, Slipchenko MN, et al. A multimodal platform for nonlinear optical microscopy and microspectroscopy [J]. Opt Express, 2009, 17 (3): 1282-1290.
[9]
Adler DD, Carson PL, Rubin JM, et al. Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings [J]. Ultrasound Med Biol, 1990, 16 (6): 553-559.
[10]
Mercado CL. BI-RADS update [J]. Radiol Clin North Am, 2014, 52 (3): 481-4877.
[11]
Park CS, Lee JH, Yim HW, et al. Observer agreement using the ACR Breast Imaging Reporting and Data System (BI-RADS)-ultrasound, First Edition (2003) [J]. Korean J Radiol, 2007, 8 (5): 397-402.
[12]
Onitilo AA, Engel JM, Liang H, et al. Mammography utilization: patient characteristics and breast cancer stage at diagnosis [J]. AJR Am J Roentgenol, 2013, 201 (5): 1057-1063.
[13]
Yoon JH, Kim MJ, Kim EK, et al. Imaging Surveillance of Patients with Breast Cancer after Primary Treatment: Current Recommendations [J].Korean J Radiol, 2015, 16 (2): 219-228.
[14]
史春颖,陈颖.小乳癌的数字化乳腺摄影与超声成像对比研究[J].实用放射学杂志, 2007, 23(8): 1103-1105.
[15]
伍尧伴,林浩皋,蔡培强. 18例小乳癌的钼靶、CT与病理对照分析[J].影像诊断与介入放射学, 2013, 12 (2): 152.
[16]
李宇明,郑金霞,陈慧.钼靶摄影与超声成像对小乳癌的诊断对比[J].中国误诊学杂志, 2009, 9 (15): 3550.
[17]
Moy L, Slanetz PJ, Moore R, et al. Specificity of mammography and US in the evaluation of a palpable abnormality: retrospective review [J]. Radiology, 2002, 225 (1): 176-181.
[18]
Warner E, Messersmith H, Causer P, et al. Systematic review: Using magnetic resonance imaging to screen women at high risk for breast cancer [J]. Ann Intern Med, 2008, 148 (9): 671-679.
[19]
韩莉.钼靶与MRI检查对小乳癌诊断的对比分析研究[J].中国实验诊断学, 2014, 18 (9): 1530-1532.
[20]
Keyserlingk JR, Ahlgren PD, Yu E, et al. Functional infrared imaging of the breast [J]. IEEE Eng Med Biol Mag, 2000, 19 (3): 30-41.
[21]
Fibich G, Hammer A, Gannot G, et al. Modeling and simulations of the pharmacokinetics of fluorophore conjugated antibodies in tumor vicinity for the optimization of fluorescence-based optical imaging [J]. Lasers Surg Med, 2005, 37 (2): 155-160.
[22]
Xiao J, He ZZ, Yang Y, et al. Investigation on three-dimensional temperature field of human knee considering anatomical structure [J]. Int J Heat Mass Tran, 2011, 54 (9-10): 851-1860.
[23]
Shi G, Han F, Wang L, et al. Q-r curve of thermal tomography and its clinical application on breast tumor diagnosis [J].Biomed Opt Express, 2015, 6 (4): 1109-1123.
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