科创中国

目的 探讨常规超声按照乳腺影像报告及数据系统(BI-RADS)标准与超声弹性应变率比值法对触诊阴性乳腺肿块的诊断价值.方法 常规超声检查按照BI-RADS-US标准将85例患者91个触诊阴性乳腺病灶进行分级,并于穿刺活检或手术切除前进行超声弹性应变率比值法测定.以病理诊断为金标准,构建受试者应用工作特征曲线( ROC),比较2种不同方法的诊断价值.结果 触诊阴性乳腺恶性病灶弹性应变率比值远大于良性病灶(分别为6.92±5.91和2.49±3.26),两者比较差异显著(P<0.01);弹性应变率比值法与BI RADS-US标准的曲线下面积(AUC)分别为0.891和0.818.两者比较差异无统计学意义(P>0.05);2种方法联合应用构建ROC曲线AUC为0.976,与BI-RADS-US标准比较差异有统计学意义(P<0.01),与弹性应变率比值法比较差异有统计学意义(P<0.05).结论 弹性应变率比值法对触诊阴性乳腺病灶的良恶性评估价值明显;常规超声与超声弹性成像联合应用有助于判断触诊阴性乳腺病灶的良恶性,具有重要的临床应用价值.

Objective Immediate physical exercise has been recommended for patients in the recovery phase to improve survival and quality of life(QOL)and reduce recurrence of disease.The new NCCN Guidelines for Survivorship also highlighted the role of exercise in post-cancer health,encouraging patients to perform light physical activity following treatment.The aim of our study is to effect of Tai Chi Chuan(TCC)on serotonin and cortisol for monitoring stress and QOL in post-treatment breast cancer patients.Methods Totally85 post-treatment breast cancer patients were enrolled in this study to observe the effects of practicing TCC on recovery,as well as stress and happiness which are indicators of QOL of in patients.Peripheral blood was drawn from study subjects to analyze the levels of serotonin,cortisol and high sensitive C-reactive protein(HSCRP)at baseline,and at 3,6 and 12 months of TCC practice.Blood was drawn from healthy subjects only at baseline.A QOL questionnaire was administered to study subjects at three time points throughout the study,and once for healthy controls.The data were processed by analysis of variance of repeated measurement.Results At 3,6 and 12 months time points following regular TCC exercise,WBC,RBC,hemoglobin in blood samples showed a statistically significant difference(F=161.55,172.14,289.73;all P=0.00);the level of serotonin(biomarker for well-being),cortisol(indicator of stress)and HS-CRP(biomarker for inflammation)showed a statistical improvement(F=307.46,182.85,102.23;all P=0.00).After 3,6 and 12 months of regular TCC exercise,according to the results of QOL questionnaire,the indicators including quality of sleep,perceived hunger,fatigue,contentment,stress and social interaction presented a significant difference(F=312.98,222.64,543.90,46.05,28.10,78.92,all P<0.05),while there was no statistical difference in life dissatisfaction(F=56.61,P=0.166)Conclusions TCC physical activity for post-treatment breast cancer patients improved QOL and overall well-being,leading to improved mental,physical and psychological functioning.Regulated levels of serotonin and cortisol mediated by TCC exercises are proved to be vital for continued good health.

目的 探讨高频彩色多普勒超声对乳腺髓样癌的诊断价值,分析超声误诊原因.方法 回顾性分析经手术病理证实的26例乳腺髓样癌的超声表现,归纳其声像图特征,总结导致误诊的原因.结果 乳腺髓样癌具有特征性声像图表现,包括边界清楚但无包膜、形态尚规则、内部回声低而后方回声增强、血供丰富等.超声诊断符合率81% (21/26),19%(5/26)误诊为纤维腺瘤.结论 高频彩色多普勒超声对乳腺髓样癌诊断符合率较高,分析其误诊原因有利于进一步提高对本病声像图特征的认识,减少误诊.