摘要
目的 探讨乳腺癌超声多模态成像参数与糖类抗原 153(CA153)、125(CA125)表达相关性及诊断价值.方法 选取我院收治的女性乳腺单发结节患者 260 例,根据术后病理结果分为恶性组和良性组,其中乳腺癌患者 109 例为恶性组,乳腺良性肿瘤 151 例为良性组,分析应用超声多模态成像参数联合血清肿瘤标志物对乳腺肿瘤良恶性的鉴别诊断价值.结果 恶性组肿块的最大血流速度、血流阻力指数及搏动指数均高于良性组,差异均有统计学意义(P<0.05);恶性组肿块超声造影时间-强度曲线的峰值强度、上升支斜率及梯度均高于良性组,而达峰时间则短于良性组,差异均有统计学意义(P<0.05);恶性组CA153 及CA125 水平均高于良性组,差异有统计学意义(P<0.05);恶性组患者除达峰时间与血清CA153及CA125均呈负相关外,其余超声指标均与血清CA153及CA125呈正相关(P<0.05);多因素Logistic回归分析,结果发现最大血流速度、血流阻力、搏动指数、峰值强度、上升支斜率、达峰时间、梯度、CA153、CA125 是乳腺恶性结节独立危险因素(P<0.05);ROC曲线结果显示超声血流参数、超声造影、CA153、CA125 及联合应用的AUC分别为 0.812、0.890,0.712、0.634 及 0.953;联合应用的诊断效能明显高于超声血流参数、超声造影、CA153、CA125(P<0.05).结论 超声多模态成像参数联合血清肿瘤标志物对乳腺肿瘤良恶性的鉴别诊断性能较高,具有很好的临床应用价值.
Abstract
Objective To investigate the correlation and diagnostic value of ultrasound multimodal imaging parameters with CA153 and CA125 expression in breast cancer.Methods A total of 260 female breast nodule patients admitted to our depart-ment,all of whom were single nodules,were divided into a study group and a control group based on postoperative pathological findings,of which 109 patients with breast cancer were in the study group and 151 patients with benign breast tumour were in the control group.Then,we analysed the value of applying ultrasound multimodal imaging parameters in conjunction with serum tu-mour markers for the differential diagnosis of benign and malignant breast tumours.Results The maximum blood flow,resis-tance index and pulsatility index of the study group were higher than those of the control group(P<0.05);The peak intensity,slope of ascending branch and gradient of the study group were higher than those of the control group,while,the peak time was shorter than those of the control group(P<0.05);The levels of CA153 and CA125 of the study group were higher than those of the control group(P<0.05);All ultrasound indicators were positively correlated to serum CA153 and CA125 of the breast cancer patients(P<0.05),except for the negative correlation of peak time with both CA153 and CA125.Multivariate Logistic regression analysis showed that maximum blood flow velocity,blood flow resistance,pulse index,peak intensity,ascending branch slope,peak time,gradient,CA153 and CA125 were independent risk factors for malignant breast nodular lesions(P<0.05).The re-sults of ROC curve showed that the AUCs of ultrasound blood flow signal,ultrasonography,CA153,CA125 and combined appli-cation were 0.812,0.890,0.712,0.634,and 0.953,respectively.The diagnostic efficacy of combined application was higher than that of ultrasound blood flow signal,contrast-enhanced ultrasound,CA153,and CA125(P<0.05).Conclusion Ultra-sound multimodal imaging parameters combined with serum tumour markers have high differential diagnostic power for benign and malignant breast tumours.
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