■分析乳腺硬化性腺病(SA)和浸润性导管癌(IDC)的临床和超声特征。并构建SA的预测列线图。
■2016年1月至2022年11月,山东大学第二医院共招募865名患者。所有患者术前均行常规乳腺超声检查,手术后通过组织病理学检查证实了诊断。使用乳腺成像数据和报告系统(BI-RADS)记录超声特征。865名患者中,203个(252个结节)诊断为SA,662个(731个结节)诊断为IDC。以6:4的比例将它们随机分为训练集和验证集。最后,临床特征与超声特征的差异进行对比分析。
■SA和IDC的多种临床和超声特征差异有统计学意义(P<0.05)。随着年龄和病变大小的增加,SA的概率显著降低,截止值为36岁和10毫米,分别。在训练集的逻辑回归分析中,年龄,结节大小,更年期状态,临床症状,病变的可触及性,边距,内部回声,彩色多普勒血流显像(CDFI)分级,与耐药指数(RI)比较差异有统计学意义(P<0.05)。这些指标包括在静态和动态列线图模型中,显示出高预测性能,训练集和验证集的校准和临床价值。
■无症状的年轻女性应怀疑SA,尤其是年龄小于36岁的人,存在小尺寸病变(特别是小于10毫米),边缘明显,均匀的内部回波,缺乏血液供应。列线图模型可以为临床医生提供更方便的工具。
UNASSIGNED: To analyze the clinical and ultrasonic characteristics of breast sclerosing adenosis (SA) and invasive ductal carcinoma (IDC), and construct a predictive nomogram for SA.
UNASSIGNED: A total of 865 patients were recruited at the Second Hospital of Shandong University from January 2016 to November 2022. All patients underwent routine breast ultrasound examinations before surgery, and the diagnosis was confirmed by histopathological examination following the operation. Ultrasonic features were recorded using the Breast Imaging Data and Reporting System (BI-RADS). Of the 865 patients, 203 (252 nodules) were diagnosed as SA and 662 (731 nodules) as IDC. They were randomly divided into a training set and a validation set at a ratio of 6:4. Lastly, the difference in clinical characteristics and ultrasonic features were comparatively analyzed.
UNASSIGNED: There was a statistically significant difference in multiple clinical and ultrasonic features between SA and IDC (P<0.05). As age and lesion size increased, the probability of SA significantly decreased, with a cut-off value of 36 years old and 10 mm, respectively. In the logistic regression analysis of the training set, age, nodule size, menopausal status, clinical symptoms, palpability of lesions, margins, internal echo, color Doppler flow imaging (CDFI) grading, and resistance index (RI) were statistically significant (P<0.05). These indicators were included in the static and dynamic nomogram model, which showed high predictive performance, calibration and clinical value in both the training and validation sets.
UNASSIGNED: SA should be suspected in asymptomatic young women, especially those younger than 36 years of age, who present with small-size lesions (especially less than 10 mm) with distinct margins, homogeneous internal echo, and lack of blood supply. The nomogram model can provide a more convenient tool for clinicians.