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计算机断层扫描在评估墨西哥乳腺癌患者骨密度中的敏感性和特异性

Sensitivity and Specificity of Computed Tomography in the Evaluation of Bone Mineral Density in Mexican Patients with Breast Cancer.

作者信息

Amador Martínez Ana, Lara Padilla Eleazar, Pérez Rodríguez Juan Antonio, Alfaro Alfonso, Solis Cano Dania Guadalupe, Bandala Cindy, Guzman Nancy

机构信息

Radiology, Centro Médico ABC, CDMX, MEX.

Medicine, Instituto Politécnico Nacional, CDMX, MEX.

出版信息

Cureus. 2019 Aug 28;11(8):e5505. doi: 10.7759/cureus.5505.

Abstract

Introduction Breast cancer (BC) is the most frequently reported cancer among women - reported in 2012 as 25% of all cancers. BC has been related to the increased life and activity of osteoclasts, conferring a higher risk for osteoporosis/osteopenia. This study aimed to determine a cut-off point in Hounsfield units (HU) as well as the sensitivity and specificity of computed axial tomography (CT) in the diagnosis of osteoporosis/osteopenia in Mexican women with BC. Material and methods We included 108 patients with a histopathological diagnosis of BC treated at the ABC Medical Center in Mexico City. All patients were subjected to both dual X-ray densitometry and CT. The receiver operating characteristic (ROC) curve was used to identify the cutoff point and sensitivity and specificity were calculated, as were confidence intervals for the diagnoses of osteoporosis/osteopenia. Results The mean age was 58.49 ± 11.01 years. The cutoff point with the highest sensitivity (82%) and specificity (68%) was <157 HU for osteoporosis/osteopenia in patients with BC. Conclusions Women with BC are exposed to several risk factors for osteoporosis/osteopenia. The CT obtained for the general evaluation of these patients can also be used to evaluate bone mineral density, avoiding additional examinations and exposure to radiation, as well as the cost it confers, offering an earlier diagnosis of osteoporosis/osteopenia for its control.

摘要

引言

乳腺癌(BC)是女性中报告最为频繁的癌症——2012年报告显示其占所有癌症的25%。乳腺癌与破骨细胞的活性增加有关,会使骨质疏松/骨质减少的风险更高。本研究旨在确定豪斯菲尔德单位(HU)的一个临界点,以及计算机断层扫描(CT)在诊断墨西哥乳腺癌女性骨质疏松/骨质减少中的敏感性和特异性。

材料与方法

我们纳入了在墨西哥城ABC医疗中心接受治疗的108例经组织病理学诊断为乳腺癌的患者。所有患者均接受了双能X线骨密度测定和CT检查。采用受试者操作特征(ROC)曲线来确定临界点,并计算敏感性和特异性,以及骨质疏松/骨质减少诊断的置信区间。

结果

平均年龄为58.49±11.01岁。乳腺癌患者骨质疏松/骨质减少的临界点为<157 HU时,敏感性最高(82%),特异性为(68%)。

结论

乳腺癌女性面临多种骨质疏松/骨质减少的风险因素。对这些患者进行常规评估所获得的CT也可用于评估骨密度,避免额外检查、辐射暴露及其带来的费用,为控制骨质疏松/骨质减少提供早期诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fd/6816528/522f4c306432/cureus-0011-00000005505-i01.jpg

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