摘要
目的探究彩色多普勒超声(彩超)参数联合血清人表皮生长因子受体2(CerbB-2)检测对乳腺结节性质的鉴别诊断价值。方法回顾性分析2019年10月至2023年12月于河南省第二人民医院收治的87例乳腺结节患者的临床诊治资料,以手术或病理活检结果为金标准将患者分为良性组52例和恶性组35例,比较两组患者的超声声像图特征、彩超参数及血清CerbB-2水平,采用受试者工作特性(ROC)曲线分析彩超参数联合血清CerbB-2对乳腺恶性结节的鉴别诊断价值;比较不同病理特征患者的彩超参数及血清CerbB-2水平,采用Spearman法分析彩超参数及血清CerbB-2水平与不同临床病理特征的相关性。结果良性组、恶性组患者在肿块形状、内部回声、纵横比、后方回声减弱、微小钙化、边界及血流信号方面比较差异均有统计学意义(P<0.05);恶性组患者入院时的阻力指数(RI)、搏动指数(PI)、收缩期峰值速度(PSV)值及血清CerbB-2水平明显高于良性组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,彩超参数联合血清CerbB-2水平诊断乳腺恶性结节的曲线下面积(AUC)为0.866(95%CI:0.841~0.891),最佳诊断敏感度为94.29%,特异度为78.85%,高于各项指标单独诊断(P<0.05);不同分化程度恶性乳腺结节患者入院时RI、PI、PSV值及血清CerbB-2水平比较,低分化>中分化>高分化,而存在淋巴结转移者入院时RI、PI、PSV值及血清CerbB-2水平明显高于无淋巴结转移者,差异均有统计学意义(P<0.05);经Spearman法相关性分析结果显示,RI、PI、PSV值及血清CerbB-2水平与分化程度呈负相关(r=-0.516、-0.625、-0.584、-0.671,P<0.05),与淋巴结转移呈正相关(r=0.527、0.569、0.613、0.597,P<0.05)。结论彩超参数联合血清CerbB-2水平诊断在乳腺结节定性诊断中具有较高的诊断敏感度,可为临床早期诊断、选择相应治疗方案提供可靠依据。
Objective To explore the value of color Doppler ultrasound parameters combined with serum human epidermal growth factor receptor 2(CerbB-2)detection in the differential diagnosis of benign and malignant breast nodules.Methods The clinical data of 87 patients with breast nodules admitted to the Second People's Hospital of Henan Province from October 2019 to December 2023 were retrospectively analyzed.Patients were divided into benign group of 52 cases and malignant group of 35 cases based on the results of surgery or pathological biopsy as the gold standard.The ultrasonic imaging characteristics,color Doppler ultrasound parameters,and serum CerbB-2 levels of the two groups of patients were compared.The diagnostic value of color Doppler ultrasound parameters combined with serum CerbB-2 for the differential diagnosis of malignant breast nodules was analyzed using receiver operating characteristic(ROC)curve.The color Doppler ultrasound parameters and serum CerbB-2 levels of patients with different pathological characteristics were compared.The correlation between color Doppler ultrasound parameters and serum CerbB-2 levels and different clinical pathological characteristics was analyzed using Spearman correlation analysis.Results There were statistically significant differences in the shape,internal echo,aspect ratio,posterior echo attenuation,microcalcification,boundary,and blood flow signals between the benign and malignant groups(P<0.05).The resistance index(RI),pulsatility index(PI),peak systolic velocity(PSV)values and serum CerbB-2 levels of patients in the malignant group were significantly higher than those in the benign group at admission(P<0.05).ROC analysis showed that the combination of ultrasound parameters and CerbB-2 achieved an AUC of 0.866(95%CI:0.841-0.891),with a sensitivity of 94.29%and specificity of 78.85%,outperforming individual parameters(P<0.05).RI,PI,PSV,and CerbB-2 levels were higher in patients with poorly differentiated tumors(low differentiation>medium differentiation>high differentiation,P<0.05),and the levels at admission were significantly higher in patients with lymph node metastasis than those without lymph node metastasis(P<0.05).Spearman correlation analysis results showed that RI,PI,PSV values and serum CerbB-2 levels were negatively correlated with differentiation degree(r=-0.516,-0.625,-0.584,-0.671,P<0.05),and positively correlated with lymph node metastasis(r=0.527,0.569,0.613,0.597,P<0.05).Conclusion Color ultrasound parameters combined with serum CerbB-2 level has a high diagnostic sensitivity in the qualitative diagnosis of breast nodules,which can provide a reliable basis for early clinical diagnosis and selection of appropriate treatment.
作者
苏国玲
王亚萍
孙世强
张莉敏
SU Guo-ling;WANG Ya-ping;SUN Shi-qiang;ZHANG Li-min(Department of Ultrasound,the Second People's Hospital of Henan Province,Zhengzhou 451191,Henan,CHINA)
出处
《海南医学》
2025年第6期842-846,共5页
Hainan Medical Journal
基金
河南省联合共建项目(编号:LHGJ20221000)。
关键词
乳腺结节
彩色多普勒超声
人表皮生长因子受体
联合诊断
鉴别诊断
Breast nodules
Color Doppler ultrasound
Human epidermal growth factor receptor
Combined diagnosis
Differential diagnosis
作者简介
第一作者:苏国玲(1981-),女,副主任医师,主要研究方向为超声诊断;通讯作者:张莉敏(1979-),女,副主任医师,主要研究方向为心脏及血管疾病的超声诊断,E-mail:1483974742@qq.com。
