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目的:用受试者工作特性(ROC)曲线评价乳腺癌常用诊断方法。方法:对经手术病理确诊的38例乳腺癌患者和50例乳腺良性疾病患者的临床资料进行回顾性分析,术前均行临床查体、超声检查和乳腺X射线摄影术,以手术病理诊断为金标准,用Med Calc12.0软件绘制ROC曲线并计算曲线下面积(AUC)。结果:3种方法诊断乳腺癌的AUC均>0.7,差异无统计学意义。诊断方法联合应用后AUC均增加,临床查体、超声检查联合诊断的AUC明显高于临床查体(z=2.275,P<0.05),临床查体、超声检查、乳房X线摄影术联合诊断的AUC明显高于临床查体(z=2.096,P<0.05),其余各组间的差异均无统计学意义,P>0.05。结论:临床查体、超声检查和乳腺X射线摄影术均是有效诊断乳腺癌的方法,临床查体、超声检查联合应用可提高临床查体的诊断价值。在我国,特别是基层医院,可采用临床查体结合超声检查方法诊断乳腺癌,无需重复选择乳房X射线摄影术和超声检查。
Objective: To evaluate the diagnostic methods commonly used in breast cancer using the receiver operating characteristic (ROC) curve. Methods: The clinical data of 38 patients with breast cancer and 50 patients with benign breast disease diagnosed by operation and pathology were retrospectively analyzed. All patients underwent preoperative biopsy, ultrasonography and mammography before operation, Gold standard, using Med Calc12.0 software draw ROC curve and calculate the area under the curve (AUC). Results: The AUCs of the three methods for the diagnosis of breast cancer were all> 0.7, the difference was not statistically significant. The AUC of the diagnostic method combined with the application increased, the AUC of clinical examination combined with ultrasound examination was significantly higher than that of clinical examination (z = 2.275, P <0.05), clinical examination, ultrasound examination, mammography combined diagnosis AUC was significantly higher than that of clinical examination (z = 2.096, P <0.05). There was no significant difference between the other groups (P> 0.05). Conclusion: Clinical examination, ultrasonography and mammography are the effective methods to diagnose breast cancer. Combined with clinical examination and ultrasonography can improve the diagnostic value of clinical examination. In our country, especially in grassroots hospitals, we can diagnose breast cancer by using clinical examination combined with ultrasonography, without repeated choice of mammography and ultrasonography.