摘要
Abstract
Background Early diagnosis of breast cancer is crucial for its prognosis.Both contrast-enhanced ultrasound and miR-21 levels contribute to the early diagnosis of breast cancer.However,it is unclear whether the combination of miR-21 with conventional ultrasound(US)and contrast-enhanced ultrasound(CEUS)can further improve the accuracy of early diagnosis of breast cancer.Objective To analyze the application value of US and CEUS combined with plasma exosomes miR-21 in the diagnosis of breast diseases.Methods From December 2022 to April 2023,306 patients(182 benign and 124 malignant)who underwent routine breast ultrasound,CEUS examination,miR-21 test and had clear pathological results in the Department of Ultrasound Diagnosis of Chinese PLA General Hospital were collected prospectively.The diagnostic efficacy of conventional ultrasound,contrast-enhanced ultrasound,and miR-21 in breast lesions was compared and analyzed.Results There were 182 cases of benign breast lesions,with an average age of(43.62±11.38)years,and 124 cases of malignant lesions,with an average age of(51.98±10.56)years.The age between the two groups showed statistically significant difference(P<0.001).The relative expression of plasma exosomal miR-21 in the breast malignant group was 1.222(IQR:1.050-1.467),which was higher than 0.780(IQR:0.630-0.960)in the benign group,and the difference was statistically significant(P<0.001).The sensitivity,specificity,accuracy and the area under the curve(AUC)of routine ultrasound in the diagnosis of breast cancer were 70.1%,83.5%,78.1%and 0.803,respectively;They were 81.5%,87.4%,85.0%and 0.898 of conventional ultrasound combined with contrast-enhanced ultrasound,and 91.1%,85.7%,87.9%and 0.948 of miR-21 combined with conventional ultrasound and contrast-enhanced ultrasound.The diagnostic efficacy of miR-21 combined with conventional ultrasound and contrast-enhanced ultrasound was significantly higher than that of conventional ultrasound(P＜0.001)and conventional ultrasound combined with contrast-enhanced ultrasound(P＜0.001).Conclusion The combination of contrast-enhanced ultrasound and plasma exosomes miR-21 can significantly improve the diagnostic efficacy of breast lesions.关键词
乳腺癌/常规超声/超声造影/血浆外泌体/microRNAKey words
breast cancer/conventional ultrasound/contrast-enhanced ultrasound/plasma exosomes/microRNA分类
医药卫生
