史丽群, 李照喜, 师明莉, 朱绘绘, 闵贤, 王美晨, 黄璐, 李文. 上海市退休女干部乳腺微小癌影响因素的泊松回归分析及对应检测方法的诊断效能分析[J]. 职业卫生与应急救援, 2021, 39(6): 631-636. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.005
引用本文: 史丽群, 李照喜, 师明莉, 朱绘绘, 闵贤, 王美晨, 黄璐, 李文. 上海市退休女干部乳腺微小癌影响因素的泊松回归分析及对应检测方法的诊断效能分析[J]. 职业卫生与应急救援, 2021, 39(6): 631-636. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.005
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SHI Liqun, LI Zhaoxi, SHI Mingli, ZHU Huihui, MIN Xian, WANG Meichen, HUANG Lu, LI Wen. Poisson regression analysis of influencing factors of minimal breast cancer in female retired cadres in Shanghai[J]. Occupational Health and Emergency Rescue, 2021, 39(6): 631-636. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.005
Citation: SHI Liqun, LI Zhaoxi, SHI Mingli, ZHU Huihui, MIN Xian, WANG Meichen, HUANG Lu, LI Wen. Poisson regression analysis of influencing factors of minimal breast cancer in female retired cadres in Shanghai[J]. Occupational Health and Emergency Rescue, 2021, 39(6): 631-636. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.005
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上海市退休女干部乳腺微小癌影响因素的泊松回归分析及对应检测方法的诊断效能分析

Poisson regression analysis of influencing factors of minimal breast cancer in female retired cadres in Shanghai

    摘要
  • 摘要:
      目的  探析上海市退休女干部乳腺微小癌患病情况、影响因素及对应检测方法的诊断效能，为后续诊断预防提供科学依据。
      方法  对2017年1月—2019年12月定期接受体检的12 867例上海市退休女干部病历资料做回顾性分析。对体检对象先行乳腺查体及常规超声检查，检查为疑似乳腺微小癌患者再进行乳腺全容积成像（ABVS）联合数字钼靶（MG）检查，并以病理学方法进行确诊；采用泊松回归分析乳腺微小癌的影响因素；对各检验方法的诊断结果进行一致性检验，分析其诊断效能。
      结果  12 867名退休女干部检出疑似乳腺微小癌患者2 924例，经病理方法确诊有10例为乳腺微小癌。2017年、2018年及2019年乳腺微小癌检出率分别为69.99/10万、74.74/10万及87.59/10万。总体检出率为77.72/10万。泊松回归分析结果显示：年龄≥ 50岁、超重肥胖、有乳腺相关疾病遗传史、有X线照射史、有职业压力、未行母乳哺乳、绝经、有既往激素服用史、有甲状腺疾病史、未婚或丧偶、有子宫肌瘤史均为乳腺微小癌的危险影响因素（OR = 1.137 ~ 2.296，P < 0.05）。3种方法（ABVS、MG及ABVS+MG联合）和确诊病例的一致性Kappa值分别为0.889、0.823、1.000（P < 0.05）；灵敏度均> 0.700，特异性均≥ 0.999，准确性> 0.999。确诊的10例乳腺微小癌患者中，经ABVS诊断出8例，有2例误诊为良性病变；经MG诊断出7例，3例误诊为良性病变。
      结论  上海市退休女干部乳腺微小癌患病率较高，且受多种高危因素影响。推荐采用ABVS联合MG技术进行常规筛查，为乳腺癌的早期诊治提供参考。

     

    Abstract:
      Objective  To analyze the prevalence status, influencing factors and diagnostic efficacy of corresponding detection methods of minimal breast cancer among female retired cadres in Shanghai, so as to provide scientific basis for follow-up diagnosis and prevention.
      Methods  The medical records of 12 867 female retired cadres in Shanghai who underwent regular physical examination from December 2016 to December 2019 were analyzed retrospectively. These subjects were examined by breast physical examination and routine ultrasound, and the cases with suspected minimal breast cancer were examined by automated breast volume scanning(ABVS)combined with mammography(MG), and diagnosed by pathological method; Poisson regression was used to analyze the influencing factors of breast cancer. The consistency of the diagnostic results of each method was tested, and its diagnostic efficiency was analyzed.
      Results  Totally 2 924 cases were detected as suspected minimal breast cancer in 12 867 female retired cadres, and 10 cases were diagnosed as minimal breast cancer by pathological methods. The detection rates of minimal breast cancer in 2017, 2018 and 2019 were 69.99/105, 74.74/105 and 87.59/105, respectively. The total physical examination rate was 77.72/105. Poisson regression analysis showed that age ≥ 50 years old, overweight and obesity, genetic history of breast related diseases, history of X-ray irradiation, occupational stress, failure to breastfeed, menopause, history of previous hormone use, history of thyroid disease, unmarried or widowed, and history of hysteromyoma were risk factors for minimal breast cancer(OR = 1.137 - 2.296, P < 0.05). The consistency Kappa values of three methods (ABVS, MG and ABVS + MG combination)and confirmed cases were 0.889, 0.823 and 1.000, respectively (P < 0.05);the sensitivity was > 0.700, the specificity was > 0.999, and the accuracy was > 0.999. Among 10 patients with minimal breast cancer, 8 cases were diagnosed by ABVS, and 2 cases were misdiagnosed as benign lesions; 7 cases were diagnosed by MG, and 3 cases were misdiagnosed as benign lesions.
      Conclusions  There is a high prevalence of minimal breast cancer among female retired cadres in Shanghai, which is affected by many high-risk factors. ABVS combined with MG technology is recommended for routine screening, so as to provide reference for early diagnosis and treatment of breast cancer.

     

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