[热带地区用户使用乳腺病变BI-RADS分类预测恶性肿瘤的表现]

[Performance of users in tropical areas with the BI-RADS classification of breast lesions for predicting malignancy].

作者信息

Gonsu Kamga J E, Moifo B, Sando Z, Guegang Goudjou E, Nko'o Amvene S, Gonsu Fotsin J

机构信息

Faculté de médecine et des sciences biomédicales, université de Yaoundé I.

Faculté de médecine et des sciences biomédicales, université de Yaoundé I, Service de radiologie, hôpital gynéco-obstétrique et pédiatrique de Yaoundé, BP : 4362 Yaoundé, Cameroun.

出版信息

Med Sante Trop. 2013 Oct-Dec;23(4):439-44. doi: 10.1684/mst.2013.0251.

DOI:10.1684/mst.2013.0251

PMID:24334372

Abstract

OBJECTIVES

To evaluate the diagnostic performance of radiologists in Cameroon using the BI-RADS classification to interpret mammograms and ultrasound scans together for the prediction of malignant breast lesions.

METHODS

This cross-sectional study took place at the Women's and Children's Hospital in Yaounde from July 2009 to April 2010 and included 211 women with breast lesions identified on mammograms during a breast screening campaign and subsequently assessed with ultrasonography and histology. The BI-RADS classifications of these lesions were compared to the corresponding histology results to evaluate the accuracy of predictions of malignancy from the mammograms and ultrasound scans interpreted with the BI-RADS system. The rate of malignancy in each ACR-classified category was also compared to the standard ACR categories as stipulated in the ACR classification.

RESULTS

In all, 339 women aged from 16 to 78 years were screened, and lesions requiring biopsies were identified for 211. The age group included most often was the 41-50 year-old group (n = 98, 46.4%). Overall, 135 (64%) women had benign lesions and 76 (36%) malignant. Invasive carcinoma was found in 49 (65%) of the malignant lesions, in situ intraductal carcinoma in 23 (30%), and sarcoma in 4 (5%). Based on the BI-RADS classification, 124 (58.7%) breast lesions were classified as ACR2, 15 (7.1%) as ACR3, 44 (20.8%) as ACR4, and 28 (13.3%) as ACR5. Comparison of the BI-RADS classification and the histological findings showed that 19% of ACR2-classified lesions were malignant, 13% of those classified ACR3, 66% ACR4, and 75% ACR5. The global accuracy in the prediction of malignancy the BI-RADS classification was 77.3%.

CONCLUSION

The accuracy of the radiologists using the BI-RADS classification in our hospital was good at 77.3%, although shortcomings in the evaluation and interpretation of some lesions resulted in a relatively high prevalence of malignant lesions in categories ACR2 and ACR3.

摘要

目的

评估喀麦隆放射科医生使用乳腺影像报告和数据系统（BI-RADS）分类法同时解读乳房X光片和超声扫描结果以预测乳腺恶性病变的诊断性能。

方法

这项横断面研究于2009年7月至2010年4月在雅温得的妇女儿童医院进行，纳入了211名在乳房筛查活动中乳房X光片上发现有乳腺病变，随后接受超声检查和组织学检查的女性。将这些病变的BI-RADS分类与相应的组织学结果进行比较，以评估使用BI-RADS系统解读乳房X光片和超声扫描结果对恶性病变预测的准确性。还将每个美国放射学会（ACR）分类类别的恶性率与ACR分类中规定的标准ACR类别进行比较。

结果

总共筛查了339名年龄在16至78岁之间的女性，其中211名发现需要活检的病变。最常包括的年龄组是41至50岁组（n = 98，46.4%）。总体而言，135名（64%）女性患有良性病变，76名（36%）患有恶性病变。49例（65%）恶性病变为浸润性癌，23例（30%）为导管内原位癌，4例（5%）为肉瘤。根据BI-RADS分类，124例（58.7%）乳腺病变分类为ACR2，15例（7.1%）为ACR3，44例（20.8%）为ACR4，28例（13.3%）为ACR5。BI-RADS分类与组织学结果的比较显示，ACR2分类病变中有19%为恶性，ACR3分类病变中有13%，ACR4分类病变中有66%，ACR5分类病变中有75%。BI-RADS分类对恶性病变预测的总体准确率为77.3%。