【摘要】：目的:分析319例超聲BI-RADS 3級(Φ≤2cm)乳腺結(jié)節(jié)的臨床資料及超聲特征,探討超聲BI-RADS分級3級的乳腺結(jié)節(jié)需臨床干預(yù)的相關(guān)危險因素,以期提高臨床診治水平。方法:選取2014年9月-2016年8月在新疆醫(yī)科大學第五附屬醫(yī)院319例經(jīng)初次超聲分級為BI-RADS 3級的乳腺結(jié)節(jié)(Φ≤2cm)進行隨訪。結(jié)合超聲表現(xiàn),對幾種臨床中可能影響乳腺病變進展及良惡性的因素,包括患者年齡、有無生育、是否絕經(jīng)、有無乳腺癌家族史、有無乳腺良性疾病史、病灶的數(shù)目、初潮年齡以及體重指數(shù)(BMI)進行評價。應(yīng)用統(tǒng)計軟件SPSS 17.0進行統(tǒng)計學處理,檢驗水準α=0.05。采用χ2檢驗或Fishers確切概率法進行單因素分析,多因素分析采用Logistic回歸模型計算。結(jié)果:根據(jù)319例臨床相關(guān)資料對BI-RADS 3級的乳腺結(jié)節(jié)的疾病進展的因素行單因素分析顯示年齡、絕經(jīng)、單發(fā)結(jié)節(jié)、位于外上象限、初潮年齡12歲、既往乳腺良性腫瘤史對疾病進展的影響較為顯著(P0.05),差異有統(tǒng)計學意義;多因素Logistic回歸分析結(jié)果顯示絕經(jīng)、單發(fā)結(jié)節(jié)對乳腺疾病進展的影響較為顯著(P0.05)。隨訪的319例病例中,122例出現(xiàn)疾病進展行手術(shù)治療;122例中惡性15例,良性病變107例;臨床相關(guān)單因素分析顯示邊界欠清、邊緣欠規(guī)整、初潮年齡12歲及BMI指數(shù)25Kg/m2對乳腺良惡性的影響顯著(P0.05),差異有統(tǒng)計學意義;多因素Logistic回歸分析結(jié)果顯示邊界欠清、邊緣欠規(guī)整對乳腺疾病良惡性的影響較為顯著(P0.05)。結(jié)論:絕經(jīng)、單發(fā)結(jié)節(jié)是BI-RADS 3級的疾病進展的相關(guān)危險因素;患者乳腺結(jié)節(jié)超聲表現(xiàn)邊界欠清、邊緣欠規(guī)整是BI-RADS 3級惡性變的相關(guān)危險因素,對于以上危險因素的BI-RADS 3級患者需進行臨床干預(yù),必要時微創(chuàng)手術(shù)治療,不建議患者隨訪觀察以免加重疾病進程。
[Abstract]:Objective: to analyze the clinical data and ultrasonic features of 319 Cases of ultrasound BI-RADS 3 (< < 2cm) breast nodules, and to explore the related risk factors for clinical intervention of breast nodules with BI-RADS grade 3 grade, in order to improve the level of clinical diagnosis and treatment. Methods: to select 319 Cases of primary ultrasound in Fifth Affiliated Hospital of Xinjiang Medical University in August September 2014. Follow up of breast nodules (< < < 2cm) of grade BI-RADS 3. Combined with ultrasound findings, several clinical factors that may affect the progression of breast disease and benign and malignant, including age, fertility, menopause, family history of breast cancer, history of benign breast disease, number of lesions, age of menarche, and body mass index (BMI) The statistical software SPSS 17 was used for statistical processing. The test level alpha =0.05. was analyzed by x 2 test or Fishers exact probability method for single factor analysis. The multiple factor analysis was calculated by Logistic regression model. Results: according to the clinical data of 319 cases, the factors of the disease progression of the BI-RADS 3 breast nodules were divided into single factors. Analysis showed that age, menopause, single nodule, located in the outer quadrant, the age of the menarche was 12 years old, the history of past benign breast cancer had a significant influence on the progression of the disease (P0.05), and the difference was statistically significant. The results of multiple factor Logistic regression analysis showed that the effects of menopause and single nodules on the progression of breast disease were more significant (P0.05). The 319 cases were followed up. In 122 cases, 122 cases of disease progression were operated, 122 cases were malignant, 15 cases were malignant, 107 cases were benign, and the clinical correlation single factor analysis showed that the boundary was not clear, the edge was not regular, the age of the menarche was 12 years old and the BMI index 25Kg/m2 was significant (P0.05), the difference was statistically significant; the multiple factor Logistic regression analysis showed the boundary. Conclusion: menopause and single nodules are the related risk factors for the progression of BI-RADS 3. The boundary of breast nodules in patients with breast nodules is less clear, and the margin under irregular is the risk factor for the malignant change of grade BI-RADS 3, and BI-RADS 3 for the above risk factors. Patients need clinical intervention and minimally invasive surgery if necessary. Follow-up observation is not recommended to avoid aggravating the disease process.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.9

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