中国癌症杂志 ›› 2019, Vol. 29 ›› Issue (2): 148-152.doi: 10.19401/j.cnki.1007-3639.2019.02.009

• 论著 • 上一篇    下一篇

超声筛查乳腺癌模式在基层医院应用的研究

乌拉木·玉努斯1,周 娜2,柳紫阳1,郭 瑞1,孟庆荣1,李红斌1   

  1. 1. 哈密市中心医院普外一科,新疆 哈密 839000 ;
    2. 哈密市中心医院超声科,新疆 哈密 839000
  • 出版日期:2019-02-28 发布日期:2019-03-25
  • 通信作者: 乌拉木·玉努斯 E-mail: john_wula@163.com

Ultrasound screening for the application of breast cancer model in primary hospitals

WU LAMU·Yunusi1, ZHOU Na2, LIU Ziyang1, GUO Rui1, MENG Qingrong1, LI Hongbin1   

  1. 1. First Department of General Surgery, Hami City Hospital, Hami 839000, Xinjiang Uygur Autonomous Region, China; 2. Department of Ultrasound, Hami City Hospital, Hami 839000, Xinjiang Uygur Autonomous Region, China
  • Published:2019-02-28 Online:2019-03-25
  • Contact: WU LAMU·Yunusi E-mail: john_wula@163.com

摘要: 背景与目的:乳腺癌是影响成年女性的主要慢性疾病之一,我国乳腺癌的发病率正以每年3%~4%的速率增长,严重危害女性的身体健康和生命安全。本研究旨在分析超声筛查乳腺癌模式在基层医院推广应用的可行性,探讨应用超声检查早期发现和诊断乳腺癌的价值。方法:采用基于超声筛查乳腺癌的模式,选择35~60岁哈密地区户籍的各民族妇女进行群体乳腺癌筛查,全部妇女先行乳腺超声检查,对乳腺影像报告与数据系统(Breast Imagine Reporting and Data System,BI-RADS)分级为4级和5级的行活检,0级和3级的补充乳腺X线检查,1级和2级的随访。结果:2012年1月—2017年10月全地区在本院累计完成乳腺癌检查184 680人,其中149例确诊为乳腺癌,乳腺癌检测率80.68/10万,建议行乳腺X线检查3 203人次,实际乳腺X线检查2 675人次;建议活检582人次,实际活检582人次;早期乳腺癌比例:0期36.24%,Ⅰ期51.00%,Ⅱ期10.07%,Ⅲ期2.68%,0+Ⅰ+Ⅱ期97.31%,0+Ⅰ期87.24%。灵敏度和特异度:乳腺超声筛查出122例乳腺癌(81.88%),X线检查出27例(18.12%)。35~39岁组乳腺癌检出率为8.56/10万,40~50岁组检出率为29.20/10万,51~60岁组检出率为42.71/10万。回族妇女乳腺癌检出率显著高于其他民族(P<0.05),其次为维吾尔族妇女。结论:超声筛查乳腺癌模式在基层医院易于推广,实际操作过程中筛查对象的依从性较好,易于普及,在乳腺癌的检出、早期诊断等方面效果明显。

关键词: 乳腺癌, 超声检查, 筛查模式, 诊断

Abstract: Background and purpose: Breast cancer is one of the major chronic diseases affecting adult women. The incidence of breast cancer in China is increasing at a rate of 3%-4% per year, which seriously endangers women's health. Therefore, it is necessary to explore the application of ultrasound screening mode in primary hospitals and the feasibility and application value of ultrasound screening as an early detection and diagnosis method for breast cancer in primary hospitals. Methods: Breast cancer screening based on breast ultrasonography was used to select women aged from 35 to 60 years in the Hami area to undergo the screening for breast cancer. All women underwent breast ultrasonography. The Breast Imagine Reporting and Data System (BI-RADS) grade 4 and 5 patients received biopsy, the women with BI-RADS grade 0 and grade 3 underwent X-ray examination, and those with BI-RADS grade 1 and grade 2 needed follow-up. Results: From Jan. 2012 to Oct. 2017, a total of 184 680 breast cancer examinations were completed at Hami City Hospital, and 149 women were diagnosed as having breast cancer, with a detection rate of 80.68/100 000. A total of 3 203 persons were recommended to undergo breast X-ray examination, and 2 675 persons underwent the examination eventually; 582 persons were advised to acquire the biopsy, and finally all underwent the biopsy. As for the staging results of the breast cancer patients, 36.24% patients were phase 0, 51.00% were phase Ⅰ, 10.07% were phase Ⅱ, and 2.68% were phase Ⅲ. Additionally, 97.31% patients were phase 0,Ⅰ and Ⅱ, and 87.24% were phase 0 and Ⅰ. As for the sensitivity and specificity, 122 (81.88%) breast cancer patients were detected by ultrasound, and 27 (18.12%) patients were detected by X-ray. The detection rate of breast cancer was 8.56/100 000 in the 35-39 age group, was 29.20/100 000 in the 40-50 age group, and 42.71/100 000 in the 51-60 age group. The detection rate of breast cancer in Hui people was significantly higher than that of other ethnic groups (P<0.05), followed by Uygur people. Conclusion: Breast ultrasound screening for breast cancer is easy to carry out in primary hospitals. The compliance of screening subjects in practice is fine, and it is easy to be popularized. It has achieved certain results in the detection rate and early diagnosis of breast cancer. It is an optional breast cancer screening model that is in line with China's national conditions.

Key words: Breast cancer, Ultrasonography, Screening mode, Diagnosis