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目的评价超声检查(US)、乳房X线摄影术(MAM)及两种方法联合应用对乳腺癌的诊断效能,探讨US在乳腺癌筛查和早期诊断中的作用。方法应用Meta分析方法对有关US、MAM及两种方法联合应用诊断乳腺癌的文献进行定量综合分析,按诊断策略不同分为3组,计算不同诊断方法的合并诊断比值比(DOR),然后绘制出3条综合接受者工作特征(SROC)曲线。结果共纳入8篇文献。超声诊断的合并DOR值为19.10(95%CI为12.62~28.90);MAM诊断的合并DOR值为33.07(95%CI为16.47~66.40);两种方法联合诊断的合并DOR值为78.13(95%CI为27.68~220.59)。SROC曲线分析表明,MAM比US的诊断效能高;MAM与US联合应用,可明显提高乳腺癌诊断的灵敏度,诊断效能最好。结论US对MAM早期诊断乳腺癌起重要的辅助作用。结合我国的实际情况,US可作为定期筛查乳腺癌的首选方法。
Objective To evaluate the diagnostic efficacy of ultrasound combined with mammography (MAM) and two methods in breast cancer screening and to explore the role of US in screening and early diagnosis of breast cancer. Methods Meta-analysis was used to quantitatively analyze the literature about the combined use of US, MAM and two methods in the diagnosis of breast cancer. According to the diagnostic strategy, the data were divided into three groups and the diagnostic odds ratio (DOR) of different diagnostic methods was calculated. Out of three aggregate receiver characteristics (SROC) curve. Results A total of 8 articles were included. The combined DOR value of ultrasound diagnosis was 19.10 (95% CI: 12.62-28.90); the combined DOR value of MAM diagnosis was 33.07 (95% CI: 16.47-66.40); the combined DOR value of the two methods was 78.13 (95% CI 27.68 ~ 220.59). SROC curve analysis showed that MAM had higher diagnostic efficiency than US. Combined use of MAM and US could significantly improve the diagnostic sensitivity of breast cancer, with the best diagnostic performance. Conclusions US plays an important role in early diagnosis of breast cancer by MAM. Combined with the actual situation in our country, US can be used as a regular screening method of breast cancer.