摘要
目的:评估超声乳腺影像报告和数据系统(BI-RADS)对男性乳腺癌(MBC)的诊断效能及不同临床经验超声医师的诊断一致性分析.方法:回顾分析2017年1月—2023年7月在浙江大学医学院附属第二医院接受手术的90例接受手术的男性乳腺疾病患者资料,患者均进行BI-RADS评估,并由6名超声科医师进行诊断,根据资历将6名医师分为三组.比较受试者工作特征(ROC)曲线下面积(AUC)、灵敏度、特异度、准确率、阳性预测值(PPV)和阴性预测值(NPV),并评估不同组别观察者间一致性.结果:第3组的AUC、灵敏度、准确率及PPV最高,分别为0.904、97.2%、62.9%、76.7%;第2组特异度及NPV最高,分别为75.9%、100.0%.组内相关系数在BI-RADS 2类和BI-RADS 3类表现为优秀到良好水平,在4a类结节表达为较差水平,在4b、4c和5类均表现为一般水平.三组间仅第1组和第3组诊断效果差异有统计学意义(P＜0.05).结论:超声BI-RADS对MBC具有较高应用价值,超声医师的临床经验与BI-RADS的诊断效能显著相关.
Abstract
Objective To evaluate the diagnostic efficacy of Breast Imaging Reporting and Data System for Ultrasonography(BI-RADS)for male breast cancer(MBC)and analyze the diagnostic consistency of ultrasound physicians with different clinical experiences.Methods Review and analyze the data of 90 case of male breast disease patients who underwent surgery at the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2017 to July 2023.All patients underwent BI-RADS evaluation and were diagnosed by six sonographers.Based on their different work experience,the six sonographers were divided into three groups.The area under the receiver operating characteristic curve(AUC),sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)were calculated for comparative analysis and evaluate the consistency between observers in different groups.Results The group 3 showed the best AUC,sensitivity,accuracy and PPV,which were 0.904,97.2%,62.9%and 76.7%,respectively while the group 2 showed the highest specificity(75.9%)and NPV(100.0%).Besides,the whole of three groups expressed excellent intraclass correlation efficient on 2(0.934)category and good on BI-RADS 3(0.677)category,the ICC of 4a(0.379)was expressed as poor level,the ICC of 4b(0.483),4c(0.521)and 5(0.491)was expressed as fair level.Only group 1 had significant difference with the group 3 in diagnostic effectiveness of the same systems among three groups(P<0.05).Conclusion Ultrasound BI-RADS has a high application value in the diagnosis of male breast cancer.The clinical experience of sonographers is significantly related to the diagnostic efficacy of diagnosed MBC.
维普
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