超声剪切波弹性成像联合糖类抗原15-3诊断乳腺BI-RADS 4类肿块良恶性的价值-《中国医学物理学杂志》

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Title:: Diagnostic value of shear wave elastography combined with carbohydrate antigen 15-3 for benign and malignant BI-RADS category 4 breast masses

文章编号:: 1005-202X（2025）11-1450-05

作者:: 张华莉1; 王勇2; 王禹雪1; 1.云南大学附属医院超声科，云南昆明 650021； 2.南京市第一医院（南京医科大学附属南京医院）功能检查科，江苏南京 210006

Author(s):: ZHANG Huali1; WANG Yong2; WANG Yuxue1; 1. Department of Ultrasound, Affiliated Hospital of Yunnan University, Kunming 650021, China 2. Department of Functional Inspection, Nanjing First Hospital (Nanjing Hospital, Nanjing Medical University), Nanjing 210006, China

关键词:: 超声剪切波弹性成像; 糖类抗原15-3; 乳腺肿块; 乳腺影像和报告数据系统; 鉴别诊断

Keywords:: Keywords: shear wave elastography carbohydrate antigen 15-3 breast mass breast imaging and reporting data system differential diagnosis

分类号:: R312；R737.9

DOI:: DOI:10.3969/j.issn.1005-202X.2025.11.007

文献标志码:: A

摘要:: 目的：探讨超声剪切波弹性成像（SWE）联合糖类抗原15-3（CA15-3）诊断乳腺影像和报告数据系统（BI-RADS）4类肿块良恶性的价值。方法：选取2021年12月~2024年6月期间在云南大学附属医院经手术病理诊断为乳腺肿瘤的90例患者作为研究对象，均为BI-RADS 4类肿块，依据乳腺肿瘤肿块良恶性分良性组（n=42）和恶性组（n=48），所有研究对象均行SWE检查，并采用电化学发光法测定机体血清CA15-3水平。比较良性组与恶性组患者机体血清CA15-3水平和SWE参数［弹性标准差（ESD）、平均弹性值（Emean）、最大弹性值（Emax）及乳腺肿块与同层低脂肪弹性平均值的比值（Eratio）］，采用受试者工作特征（ROC）曲线下面积（AUC）检验血清CA15-3水平、SWE参数以及联合诊断乳腺BI-RADS 4类肿块良恶性的价值。结果：恶性组SWE参数ESD、Emean、Emax、Eratio及血清CA15-3水平均高于良性组（P<0.05）；根据ROC曲线下AUC预测价值，ESD、Emean、Emax、Eratio、血清CA15-3诊断乳腺BI-RADS 4类肿块良恶性的AUC分别为0.718（95% CI：0.613~0.824）、0.791（95% CI：0.701~0.881）、0.721（95% CI：0.615~0.826）、0.721（95% CI：0.613~0.830）、0.793（95% CI：0.702~0.885），SWE参数联合血清CA15-3诊断乳腺BI-RADS 4类肿块良恶性的AUC为0.953（95% CI：0.917~0.992）。结论：SWE参数联合CA15-3诊断乳腺BI-RADS 4类肿块良恶性具有较好的效能。

Abstract:: Abstract: Objective To explore the value of shear wave elastography (SWE) combined with carbohydrate antigen 15-3 (CA15-3) in differentiating benign and malignant breast imaging and reporting data system (BI-RADS) category 4 breast masses. Methods Ninety patients with breast tumors confirmed by surgical pathology at the Affiliated Hospital of Yunnan University from December 2021 to June 2024 were enrolled, all with BI-RADS category 4 breast masses. The patients were divided into a benign group (n=42) and a malignant group (n=48) according to whether the breast masses were benign or malignant. All of them underwent SWE examination, and serum CA15-3 levels were determined using electrochemiluminescence method. Serum CA15-3 levels and SWE parameters ［elasticity standard deviation (ESD), mean elasticity value (Emean), maximum elasticity value (Emax) and the ratio of breast mass elasticity to same-layer low fat elasticity (Eratio)］ were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic performance of serum CA15-3 levels, SWE parameters, and their combination for benign and malignant BI-RADS category 4 breast masses. Results The SWE parameters (ESD, Emean, Emax, and Eratio) and serum CA15-3 levels in the malignant group were significantly higher than those in the benign group (P<0.05). The AUC values of ESD, Emean, Emax, Eratio, and serum CA15-3 levels for the diagnosis of benign and malignant BI-RADS category 4 breast masses were 0.718 (95% CI: 0.613-0.824), 0.791 (95% CI: 0.701-0.881), 0.721 (95% CI: 0.615-0.826), 0.721 (95% CI: 0.613-0.830) and 0.793 (95% CI: 0.702-0.885), respectively. Notably, SWE parameters combined with serum CA15-3 levels achieved an AUC value of 0.953 (95% CI: 0.917-0.992). Conclusion The combination of CA15-3 and SWE exhibits high efficiency in diagnosing the benign and malignant nature of BI-RADS category 4 breast masses.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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