本文選題：乳腺癌 + 鉬靶��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]擬探討鉬靶X線攝影和超聲應(yīng)用于乳腺癌診斷的意義與差別,以提高乳腺癌的臨床檢出率,為優(yōu)化影像學(xué)檢查策略提供可靠依據(jù)。[方法]回顧性分析2015年12月至2016年12月在昆明市第一人民醫(yī)院乳腺中心就診病例中,經(jīng)術(shù)前影像學(xué)檢查,術(shù)后病理報(bào)告證實(shí)的355名乳腺癌患者。對(duì)該355份病歷進(jìn)行回顧性分析,355名患者均行超聲及鉬靶檢查,隨機(jī)分為三組,單獨(dú)統(tǒng)計(jì)超聲結(jié)果的有125例病人,單獨(dú)統(tǒng)計(jì)鉬靶結(jié)果的有103例病人,統(tǒng)計(jì)組合檢測(cè)結(jié)果的有127例患者。以病理結(jié)果為金標(biāo)準(zhǔn),采用卡方檢驗(yàn)分析比較鉬靶、超聲、鉬靶聯(lián)合超聲三種檢查方法對(duì)于診斷乳腺癌的檢出率、漏診率的差異;根據(jù)患者年齡、腺體類型、影像學(xué)表現(xiàn)等著重分析超聲與鉬靶X線攝影對(duì)于乳腺癌診斷的價(jià)值對(duì)比。[結(jié)果]1.兩種檢查組合和單一超聲和單一鉬靶X線檢查相比,檢出率和漏診率有統(tǒng)計(jì)學(xué)差別。鉬靶X線檢查和超聲就檢出率和漏診率對(duì)比無統(tǒng)計(jì)學(xué)差異。2.超聲對(duì)于腫塊、異常血流和腋窩淋巴結(jié)檢出率高于乳房X線檢查,而乳房X線對(duì)微鈣化檢出率高,對(duì)于腫塊形狀是否規(guī)則,邊界是否清晰兩者無統(tǒng)計(jì)學(xué)差異。3.鉬靶X線在脂肪型及少量腺體型乳房中對(duì)乳腺癌的檢出率高于超聲,而超聲對(duì)于多量腺體型及致密型乳房乳腺癌檢查率明顯高于鉬靶X線,差別具有統(tǒng)計(jì)學(xué)意義。4.根據(jù)年齡分組,超聲與鉬靶在26-39歲年齡組與50-59、60-69歲年齡組間差異具有統(tǒng)計(jì)學(xué)意義。[結(jié)論]鉬靶X線檢查和超聲分別有各自優(yōu)勢(shì)。組合應(yīng)用可以使兩個(gè)檢查優(yōu)勢(shì)互補(bǔ),顯著提高了檢出率,降低乳腺癌漏診率。最終,最佳乳腺癌癥檢查策略需要個(gè)性化的方法,根據(jù)患者個(gè)體異質(zhì)性如年齡,風(fēng)險(xiǎn)和乳房密度等指標(biāo)選擇性應(yīng)用檢查技術(shù)。
[Abstract]:[objective] to explore the significance and difference of mammography and ultrasound in the diagnosis of breast cancer, in order to improve the clinical detection rate of breast cancer and to provide reliable basis for optimizing the imaging examination strategy. [methods] from December 2015 to December 2016, 355 patients with breast cancer confirmed by preoperative imaging examination and pathological report were retrospectively analyzed in the breast center of the first people's Hospital of Kunming City. A retrospective analysis of 355 cases was carried out. All 355 patients were examined by ultrasound and molybdenum target. The patients were randomly divided into three groups: 125 patients with single ultrasound results and 103 patients with molybdenum target results. There were 127 patients with combined results. The diagnostic rate and missed rate of breast cancer were compared by chi-square test and chi-square test according to the age of the patients, the type of glands, and the difference of the detection rate and the missed rate of breast cancer by three methods: mammography, ultrasound and mammography. Imaging findings were focused on the value of ultrasound and mammography in the diagnosis of breast cancer. [result] 1. Compared with single ultrasound and single molybdenum target X-ray examination, the detection rate and missed diagnosis rate were significantly different between the two examination combinations. There was no significant difference in detection rate and missed diagnosis rate between mammography and ultrasound. The detection rate of abnormal blood flow and axillary lymph nodes in ultrasound was higher than that in mammography, but the detection rate of microcalcification in mammography was higher than that in mammography. The detection rate of mammography for breast cancer in fat type and a few glandular type was higher than that in ultrasound, but the detection rate of ultrasound for breast cancer of multiple glandular type and dense type was significantly higher than that of mammography, the difference was statistically significant. According to the age group, the difference between ultrasound and molybdenum target was statistically significant between the age group of 26-39 years and the age group of 50-990-69 years old. [conclusion] Molybdenum target X-ray examination and ultrasound have their respective advantages. The combined application can make the two examinations complement each other, improve the detection rate and reduce the missed diagnosis rate of breast cancer. Finally, the best breast cancer screening strategy requires a personalized approach, which is selectively applied according to the patient's individual heterogeneity such as age, risk and breast density.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.9

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