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目的:掌握中山市城乡妇女乳腺癌检出率,分析乳腺触诊、高频B超和斜位单相法钼靶摄片检查对乳腺癌诊断的敏感度,评价该普查方案的先进性和普查效果,探讨具有良好投入-产出优势的普查方案。方法:2006~2008年在中山市城乡多级抽样中,采用复合式乳腺健康调查问卷,按10∶3∶1的比例对普查妇女进行乳腺触诊、高频B超和斜位单相法钼靶摄片检查,所得数据用SPSS 10.0软件进行统计分析。结果:①中山市城乡妇女乳腺癌3年平均检出率56.49/10万;农村41/10万,城区高达178.13/10万,是农村的4.5倍。②40~69岁是乳腺癌检出率的高峰年龄段。③癌前病变检出率为10.09/10万,与乳腺癌检出率的比为1∶5.6。④单纯乳腺触诊对乳腺癌病例检出的敏感度为41%,结合乳腺高频B超为74%,触诊结合斜位单相法钼靶摄片为88%,三者组合为94%。⑤临床早期癌检出率:普查组82.14%,同期门诊组57.45%,P<0.05。⑥人群乳腺癌术前诊断占91.07%,间期癌3年平均3.57%。结论:妇女乳腺癌普查应以城区为重点,将城乡40~69岁妇女纳入常规普查计划,通过基线调查,掌握当地妇女中普通人群∶触诊异常∶高危人群的比例;结合经济投入的条件,按照普查中经触诊、高频B超和斜位单相法钼靶摄片诊断的比例确定普查方案,将具有更高的卫生经济学效益。采用乳腺B I-RADS分级,对乳腺高频B超和钼靶摄片进行数字化评估,是保证保障普查质量的重要措施。
OBJECTIVE: To master the detection rate of breast cancer in urban and rural women in Zhongshan City, and to analyze the sensitivity of breast cancer diagnosis by breast palpation, high-frequency B-wave and oblique single-phase mammography to evaluate the advancedness and census Effect, to explore census programs that have good input-output advantages. Methods: From 2006 to 2008, in the multi-level sampling of urban and rural areas in Zhongshan City, the composite breast health questionnaire was used to perform the palpation of breast, the high-frequency B-ultrasound and oblique single-phase molybdenum The target film examination, the data obtained using SPSS 10.0 software for statistical analysis. Results: ① The average detection rate of breast cancer in urban and rural women in Zhongshan was 56.49 / 100000 in three years, 41/10 in rural areas and 178.13 / 100000 in urban areas, which was 4.5 times that in rural areas. ② 40 to 69 years old is the detection rate of breast cancer peak age. ③ precancerous lesions detected rate of 10.09 / 100 000, and breast cancer detection rate of 1: 5.6. ④ The sensitivity of simple breast palpation was detected in 41% of cases of breast cancer, combined with high-frequency B-74 breast, palpation combined with oblique single-phase mammography 88%, the combination of the three 94% . ⑤ clinical early detection rate of cancer: the survey group 82.14%, out-patient group 57.45%, P <0.05. ⑥ breast cancer in pre-operative diagnosis of 91.07%, 3-year interval cancer average 3.57%. Conclusion: The general survey of breast cancer in women should focus on the urban area. The urban and rural women aged 40 to 69 years should be included in the routine census program. Through the baseline survey, the average number of local women: palpation abnormality: the proportion of high-risk groups; According to the census by palpation, high-frequency B-ultrasound and oblique single-phase method of mammography to determine the ratio of the proportion of census programs will have a higher health economic benefits. The use of breast B I-RADS grading to digitize mammary B-high and molybdenum target radiographs is an important measure to ensure the quality of the census.