不同筛查方案在新疆维族女性乳腺癌筛查中的准确性及临床意义

摘要

ObjectiveTo compare the accuracy and clinical signiifcance of different screening methods for breast cancer among Xinjiang Uigur women.Method3706 cases of Xinjiang Uigur women involved in the breast cancer screening. According to the screening data, different screening methods were designed, which included CBE, HUS, MAM, HUS+MAM and HUS→MAM, accuracy of those methods were compared with parallel blinded study, the pathological diagnosis and one year follow-up results were used as the golden standard.ResultIn the result of single screening method, the sensitivity of MAM was the highest, which was 80.95%, and the sensitivity of CBE was the lowest, which was 57.14%; the positive predictive value of MAM was the lowest, which was 31.48%, and the positive predictive value of CBE was the highest, which was 52.17%. Among those 5 screening methods, the sensitivity of HUS+MAM was the highest, which was 95.24%, but its positive predictive value was the lowest, which was 29.85%; the screening method of HUS→MAM had higher sensitivity than single screening methods, which was 90.47%, and its positive predictive value was the highest among the other 4 methods, which was 55.88%.ConclusionThe screening method of HUS→MAM shows relatively high sensitivity and positive predictive value, it may be worthy of consideration for the breast cancer screening especially in economically underdeveloped areas.%目的：对比不同筛查方案在新疆维族女性乳腺癌筛查中的准确性及临床意义。方法对3706例新疆维族女性进行乳腺癌筛查。根据筛查数据共设计临床扪诊、高频超声、乳腺X线摄影、高频超声＋乳腺X线摄影、高频超声→乳腺X线摄影5种筛查方法，以病理学诊断及1年随访结果作为金标准，采用平行盲法比较5种筛查方法诊断的准确性。结果单一筛查方法中，乳腺X线摄影灵敏度最高，为80.95%，临床扪诊灵敏度最低，仅为57.14%；而乳腺X线摄影阳性预测值最低，仅为31.48%，临床扪诊阳性预测值最高，为52.17%；5种筛查方法中，高频超声＋乳腺X线摄影灵敏度最高，为95.24%，阳性预测值最低，为29.85%；高频超声→乳腺X线摄影灵敏度高于单一筛查方法，为90.47%，其阳性预测值为55.88%，高于其余4种筛查方法。结论高频超声→乳腺X线摄影具有较高的灵敏度及阳性预测值，其诊断效率及诊断费用可能更适合在经济不发达地区的乳腺癌筛查中进行推广。