【摘要】 目的 分析乳腺彩超诊断为低分类的乳腺肿物应用微创旋切术后的临床病理特征。方法 回顾性分析中山市人民医院于2008年3月至2021年12月术前彩超为低分类的乳腺肿物女性患者22 922例，其中284例患者微创旋切术后确诊为乳腺癌，探讨彩超分类与患者年龄、肿物大小、病理组织类型、分子亚型之间的关系。绘制受试者工作特征（ROC）曲线分析敏感度、特异度。结果 284例患者中术前彩超BI-RADS 2类11例、3类137例、4a类136例。组织学类型为浸润性导管癌198例，其中有68例伴部分原位癌；浸润性小叶癌19例，其中有6例伴部分原位癌；原位癌29例；黏液癌12例；其他类型癌共26例。分子亚型为Luminal A型96例，Luminal B型142例，三阴性乳腺癌37例，HER-2过表达型9例。ROC曲线分析发现彩超分类预测术前为乳腺癌的敏感度为47.9%，特异度78.1%，曲线下面积为61.8%。结论 乳腺癌患者肿瘤较小、原位癌、黏液癌及三阴性乳腺癌术前容易被乳腺彩超低估，应引起重视。更多还原

【Abstract】 Objective To analyze the clinical and pathological features of breast cancer patients with low classification breast masses diagnosed by color Doppler ultrasound after minimally invasive rotational excision resection. Methods A retrospective analysis was performed in 22 922 female patients with low breast tumors classified by color Doppler ultrasound before operation in Zhongshan City People’s Hospital from March 2008 to December 2021, among whom 284 patients were diagnosed as breast cancer by minimally invasive surgery. The relationship between color Doppler ultrasound classification and age, tumor size, pathological tissue type and molecular subtype was analyzed. Receiver operating characteristic(ROC)curve was drawn to analyze the sensitivity and specificity. Results Among the 284 patients, there were 11 cases of BI-RADS 2, 137 cases of BI-RADS 3 and 136 cases of BI-RADS 4a before operation.Histologically, there were; 198 cases of invasive ductal carcinoma, of whom 68 cases were accompanied by partial carcinoma in situ; 19 cases of invasive lobular carcinoma, including 6 cases with partial carcinoma in situ; 29 cases of carcinoma in situ; 12 cases of mucinous carcinoma; 26 cases of other types of cancer. The molecular subtypes were Luminal A type in 96 cases, Luminal B type in 142 cases, triple negative breast cancer type in 37 cases and HER-2 overexpression type in 9 cases. ROC curve showed that the sensitivity of color Doppler ultrasound underestimating before operation was 47.9%, the specificity was 78.1%, and area under curve was 61.8%. Conclusion Breast patients with smaller tumors, carcinoma in situ or mucinous carcinoma and triple negative breast cancer are easily underestimated by color Doppler ultrasound before operation, which should be taken into account.更多还原