乳腺癌腋淋巴结转移超声诊断的多因素分析  

Role of ultrasound in diagnosing axillary lymph node metastases from breast carcinoma

作　　者：于韬[1] 罗娅红[1] 那丽莉[1] 邬晓明[1] 梁凯[1] 邓元[1] 

机构地区：[1]辽宁省肿瘤医院医学影像科,辽宁沈阳110042

出　　处：《现代肿瘤医学》2009年第9期1675-1678,共4页Journal of Modern Oncology

基　　金：辽宁省科技计划重大课题项目(编号:2005225007-5);辽宁省科技计划课题项目(编号:2005225003-16)

摘　　要：目的:通过分析乳腺癌癌肿及其腋淋巴结的声像图表现,探讨癌肿及腋淋巴结声像图特征与病理学腋淋巴结转移的相关性。方法:回顾性分析应用超声检出的145例乳腺癌患者及其278枚腋淋巴结的声像图表现,采用单因素分析、多因素logistic回归及ROC曲线分析的方法,分别检验乳腺癌癌肿内血流特征及癌肿最大直径、腋淋巴结血流特征、径线比及最大皮质厚度与病理学腋淋巴结转移的相关性。结果:依据单因素分析,乳腺癌癌肿血流≥Ⅱ级者、癌肿直径较长者,对应病理学腋淋巴结转移率较高(P<0.05);周边型或混合型血流分布、径线比较小、皮质厚度较厚的腋淋巴结,其病理学淋巴结转移率较高(P<0.05)。依据多因素分析,乳腺癌癌肿直径、淋巴结径线比和皮质最大厚度与病理学腋淋巴结转移明显相关。经ROC曲线分析,腋淋巴结最大皮质厚度是判定腋淋巴结转移的较佳指标。结论:依据乳腺癌癌肿及腋淋巴结超声影像学特征评价腋淋巴结转移,具有明显的临床实用价值。Objective：To study the relation between sonographic characters of axillary lymph node metastases,including image features of breast carcinoma and those of axillary lymph nodes, and pathological findings. Methods ：To retrospectively analyze the sonographies of 145 patients with breast carcinomas who had been detected 278 axilary lymph nodes, to study the relation between the sonographic characters of axillary lymph node metastases and pathological findings,including blood supply in primary tumor and its length, blood flow in lymph node, its cortical thickness and its long to short diameter ratio. Univariate, multivariate logistic regression analyses and ROC curve were conducted to determine the value of each sonographic feature. Results ： Every sonographic feature assessed were correlated with axillary lymph node metastasis by univatriat analysis （ P 〈 0.01 ）. It was suggested that length of primary tumor, cortical thickness of lymph node and its long to short diameter ratio were the sonographic features indicating axillary lymph node metastasis, especially cortical thickness of lymph node by multivariate analysis. Cortical thickness of lymph node was the best indicator to appraise axillary lymph node metastasis by ROC curve. Conclusion：It is useful to diagnose axillary lymph node metastasis by analyzing sonographic characters of breast carcinoma and axillary lymph nodes.

关 键 词：乳腺癌 腋淋巴结 转移 超声声像图 

分 类 号：R730.41[医药卫生—肿瘤]