超声BI-RADS 3级2cm以内乳腺病灶的临床危险因素研究

发布时间：2018-08-09 20:58

【摘要】：目的:分析319例超声BI-RADS 3级(Φ≤2cm)乳腺结节的临床资料及超声特征,探讨超声BI-RADS分级3级的乳腺结节需临床干预的相关危险因素,以期提高临床诊治水平。方法:选取2014年9月-2016年8月在新疆医科大学第五附属医院319例经初次超声分级为BI-RADS 3级的乳腺结节(Φ≤2cm)进行随访。结合超声表现,对几种临床中可能影响乳腺病变进展及良恶性的因素,包括患者年龄、有无生育、是否绝经、有无乳腺癌家族史、有无乳腺良性疾病史、病灶的数目、初潮年龄以及体重指数(BMI)进行评价。应用统计软件SPSS 17.0进行统计学处理,检验水准α=0.05。采用χ2检验或Fishers确切概率法进行单因素分析,多因素分析采用Logistic回归模型计算。结果:根据319例临床相关资料对BI-RADS 3级的乳腺结节的疾病进展的因素行单因素分析显示年龄、绝经、单发结节、位于外上象限、初潮年龄12岁、既往乳腺良性肿瘤史对疾病进展的影响较为显著(P0.05),差异有统计学意义;多因素Logistic回归分析结果显示绝经、单发结节对乳腺疾病进展的影响较为显著(P0.05)。随访的319例病例中,122例出现疾病进展行手术治疗;122例中恶性15例,良性病变107例;临床相关单因素分析显示边界欠清、边缘欠规整、初潮年龄12岁及BMI指数25Kg/m2对乳腺良恶性的影响显著(P0.05),差异有统计学意义;多因素Logistic回归分析结果显示边界欠清、边缘欠规整对乳腺疾病良恶性的影响较为显著(P0.05)。结论:绝经、单发结节是BI-RADS 3级的疾病进展的相关危险因素;患者乳腺结节超声表现边界欠清、边缘欠规整是BI-RADS 3级恶性变的相关危险因素,对于以上危险因素的BI-RADS 3级患者需进行临床干预,必要时微创手术治疗,不建议患者随访观察以免加重疾病进程。
[Abstract]:Objective: to analyze the clinical data and ultrasonic features of 319 Cases of ultrasound BI-RADS 3 (< < 2cm) breast nodules, and to explore the related risk factors for clinical intervention of breast nodules with BI-RADS grade 3 grade, in order to improve the level of clinical diagnosis and treatment. Methods: to select 319 Cases of primary ultrasound in Fifth Affiliated Hospital of Xinjiang Medical University in August September 2014. Follow up of breast nodules (< < < 2cm) of grade BI-RADS 3. Combined with ultrasound findings, several clinical factors that may affect the progression of breast disease and benign and malignant, including age, fertility, menopause, family history of breast cancer, history of benign breast disease, number of lesions, age of menarche, and body mass index (BMI) The statistical software SPSS 17 was used for statistical processing. The test level alpha =0.05. was analyzed by x 2 test or Fishers exact probability method for single factor analysis. The multiple factor analysis was calculated by Logistic regression model. Results: according to the clinical data of 319 cases, the factors of the disease progression of the BI-RADS 3 breast nodules were divided into single factors. Analysis showed that age, menopause, single nodule, located in the outer quadrant, the age of the menarche was 12 years old, the history of past benign breast cancer had a significant influence on the progression of the disease (P0.05), and the difference was statistically significant. The results of multiple factor Logistic regression analysis showed that the effects of menopause and single nodules on the progression of breast disease were more significant (P0.05). The 319 cases were followed up. In 122 cases, 122 cases of disease progression were operated, 122 cases were malignant, 15 cases were malignant, 107 cases were benign, and the clinical correlation single factor analysis showed that the boundary was not clear, the edge was not regular, the age of the menarche was 12 years old and the BMI index 25Kg/m2 was significant (P0.05), the difference was statistically significant; the multiple factor Logistic regression analysis showed the boundary. Conclusion: menopause and single nodules are the related risk factors for the progression of BI-RADS 3. The boundary of breast nodules in patients with breast nodules is less clear, and the margin under irregular is the risk factor for the malignant change of grade BI-RADS 3, and BI-RADS 3 for the above risk factors. Patients need clinical intervention and minimally invasive surgery if necessary. Follow-up observation is not recommended to avoid aggravating the disease process.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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