乳腺癌腋窝淋巴结转移的X线表现与病理对照研究  

Correlative Study of Radiograph and Pathology of Axillary Lymph Nodes Metastasis in Breast Cancer

作　　者：周毅[1] 马丽华 黄健 赵红梅 

机构地区：[1]北京医科大学临床肿瘤学院

出　　处：《中国医学影像技术》1999年第12期961-962,共2页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价Ｘ 线钼靶片在乳腺癌术前评估腋窝淋巴结转移的临床价值。方法　对６０ 例乳腺癌患者做腋窝淋巴结的手术前前瞻性Ｘ线钼靶检查，观察Ｘ线片内腋窝淋巴结的形态、大小、数目，术后与病理进行对照分析。结果　６０ 例腋窝部Ｘ 线钼靶检查中，３９ 例片内显示淋巴结，敏感性为６５ ％ 。病理证实有转移的淋巴结１２ 例（ 占３０％ ），淋巴结大小在０－７～２－１ｃｍ ，平均１－５ｃｍ ，淋巴结密度均匀，形态不规则，呈分叶状，边界不清。病理淋巴结无转移２７ 例，Ｘ线片内显示淋巴结大小为０－３～２－０ｃｍ ，平均０－７ｃｍ ，淋巴结形态呈圆形或椭圆形，边缘光滑，边界清楚，淋巴结密度不均匀，中心呈稍低密度，周边密度高，呈壳状改变。结论　乳腺癌腋窝淋巴结转移Ｘ 线钼靶检查是评价转移的最简便、最基本影像学检查方法。当淋巴结最小径大于０－８ｃｍ 时，可作为评估腋窝淋巴结转移的参考诊断指标，加之边缘、形态、密度改变是诊断转移的较为可靠征象。Objective To evaluate the clinical value in determined axillary lymph nodes metastasis of breast cancer with molybdenum palladium roentgenograph. Methods Radiographs with molybdenum target tube were performed preoperatively in the axillary lymph nodes of 60 patients with breast cancer. The pattern,diameter and number of lymph nodes on the molybdenum palladium roentgenographs were noticed,and compared with pathologic results. Results The axillary lymph nodes of 39 cases were found in roentgenographs and the sensitivity was 65%,in which lymph nodes of 12 cases (30%) were confirmed metastasis by pathology. These lymph nodes were 0.7～2.1cm (average 1.5cm) in diameter,homogeneous in density,irregular and lobular in pattern,unclear at rim. No metastatic lymph nodes of 27 cases in pathologic examination showed 0.3～2.0 cm in diameter (average 0.7cm),round or oval in pattern,smoothly and sharply at rim. There was heterogeneity in density,which showed lower density in the center and high in the surrounding so forming shell like. Conclusion Radiographys with molybdenum target tube of axillary lymph nodes in breast cancer is a simply and basic radialogic method to evaluate metastasis. The minimal nodal diameter >0.8 cm combining with changes of pattern,rim and density can be used as sign for evaluated axillary lymph nodes metastasis in breast cancer. [

关 键 词：腋窝淋巴结转移 X线 钼靶检查 病理学 乳腺癌 

分 类 号：R733.404[医药卫生—肿瘤] R737.906[医药卫生—临床医学]