摘要
目的探讨高频彩色多普勒超声在乳腺癌腋窝淋巴结转移诊断中的应用价值。方法对266例乳腺癌患者的腋窝淋巴结行术前超声检查,对超声检出的152例腋窝淋巴结与术后病理结果对照,将其分为淋巴结转移组(93例)与淋巴结无转移组(59例),并对超声所显示的两组淋巴结的最大径、纵横比、皮髓比及血流分布类型行对比分析,并运用受试者工作特性(ROC)曲线进行评价。结果淋巴结转移组93例与淋巴结无转移组59例患者的淋巴结最大径分别为(18.9±6.7)mm及(19.6±7.2)mm,差异无统计学意义(P>0.05);而淋巴结转移组淋巴结的纵横比及皮髓比的中位数值分别为1.5(1～2.6)与2.0(0.8～4),与淋巴结无转移组的1.9(1～4.5)与0.5(0.2～2)比较差异均有统计学意义(均P<0.05);淋巴结转移组淋巴结血流分布以周围型及混合型居多,分别为54.5%(18/33)与30.3%(10/33);淋巴结无转移组淋巴结血流分布则以中央型居多,占63.2%(12/19)。ROC曲线分析显示:取淋巴结纵横比≤1.8对诊断淋巴结转移的敏感度及特异度分别高达62.4%与62.7%;取淋巴结皮髓比≥1.0对诊断淋巴结转移的敏感度及特异度分别高达75.3%与86.4%。结论高频彩色多普勒超声观察乳腺癌腋窝淋巴结形态,并取淋巴结的纵横比≤1.8和(或)皮髓比≥1.0进行分析,可提高乳腺癌腋窝淋巴结转移的诊断率,值得深入探讨。
Objective To investigate the value of the color Doppler ultrasonic diagnosis for metastasis of axillary lymph nodes in breast cancer. Methods The color Doppler uhrasonography was undertaken before pathologic examination to detect axillary metastatic lymph nodes in 266 patients with breast carcinoma. A total of 152 patients with axillary lymph nodes were showed by ultrasonography. They were classified into two groups according to the postoperative pathology of radical mastectomy. One group consisted of all women who had metastasis of axillary lymph nodes; the other had no metastasis of axillary lymph nodes. The uhrasonographic features observed included the maximum dimension, the long-short axis ratio, the cortex-hilum thickness ratio and the flow pattern of axillary lymph nodes on the longitudinal section. The features were analysed univariatcly to find out the interrelated factors of breast lymph nodes metastasis. The receiver operating characteristic curve （ ROC ） analysis was done to determine sensitivity and specificity of individual ultrasonographic features in distinguishing metastatic lymph nodes from the healthy one. Results The maximum dimension of axillary lymph nodes in the metastasis group was 18.9 ±6.7 mm and 19.6 ±7.2 mm in the other group. The maximum dimension of lymph nodes was not statistically significant （ P 〉 0.05 ）. The long-short axis ratio and the cortex-hilum thickness ratio of axillary lymph nodes of the metastasis group were 1-2.6,0.8-4 and 1-4.5,0.2-2 in the other group. The long-short axis ratio, the cortex-hilum thickness ratio and the flow pattern of axillary lymph nodes of the two groups were statistically significant factors （ P 〈 0.05）. A total of 54.5% （18/33） of metastatic axillary lymph nodes were peripheral flow and 30. 3% （ 10/33 ）of metastatic axillary lymph nodes were mixed type flow. And 63.2% （ 12/19 ）of metastases axillary lymph nodes were central flow. By ROC analysis, the sensitivity and specificity were 62.4% and 62.7% based on the criteria of the long-short axis ratio ≤ 1.8, the sensitivity and specificity were 75.3% and 86.4% based on the criteria of the cortex-hilum thickness ratio ≥ 1.0. Conclusion It can improve accuracy of the long-short axis ratio ≤ 1.8 and/or the cortex-hilum thickness ratio ≥ 1.0 for ultrasonic diagnosis for metastasis of axillary lymph nodes in breast cancer.
出处
《中华医学超声杂志（电子版）》
2009年第1期27-29,共3页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
乳腺肿瘤
淋巴结
肿瘤转移
彩色多普勒超声检查
Breast neoplasms
Lymph nodes
Neoplasm metastasis
Color Doppler ultrasonography
