MSCT在乳腺癌腋窝淋巴结转移术前N分期的诊断价值  

Evaluation of MSCT in diagnosis of axillary lymph nodes metastasis in preoperative N staging of breast carcinoma

作　　者：刘春英[1] 何晓鹏[1] 舒健[1] 韩福刚[1] 

机构地区：[1]泸州医学院附属医院放射科,四川泸州646000

出　　处：《实用放射学杂志》2014年第1期65-68,共4页Journal of Practical Radiology

摘　　要：目的探讨MSCT在乳腺癌腋窝淋巴结转移术前N分期的价值。方法收集术前行64层螺旋CT增强的84例乳腺癌，回顾性分析病理证实的36例腋窝淋巴结转移，将腋窝淋巴结长径增大、淋巴结结构改变判断结果与病理诊断进行一致性检验，选择优势诊断指标评估术前N分期。结果MSCT显示36例乳腺癌腋窝淋巴结544枚，转移141枚；其中201枚长径≥10mm，转移74枚，淋巴结结构改变205枚，转移130枚。采用腋窝淋巴结长径≥10mm作为转移标准与病理结果一致性极低（Kappa=0．184，P=0．000）；以腋窝淋巴结结构改变预测转移与病理诊断呈高度一致性（Kappa=0．654，P=0．000），且乳腺癌腋窝淋巴结转移术前N分期准确性为89．3％。结论MSCT观察腋窝淋巴结结构特征判定转移有较高准确性，对乳腺癌术前N分期有重要指导作用。Objective To evaluate the value of MSCT in axillary lymph nodes metastasis in N staging of the breast carcinoma be- fore operation. Methods 84 patients with breast cancer underwent preoperatively contrast-enhanced MSCT, 36 of whom with axilla ry lymph nodes metastasis were retrospectively analyzed. Kappa analysis was used to do consistency test of judgment results inclu- ding the maximum diameter increase and structural changes of the lymph nodes with pathologic results. Results 544 axillary lymph nodes in 36 patients were detected by MSCT, in which metastatic lymph nodes were 141. There were 74 metastatic nodes among 201 lymph nodes with maximum diameter greater than 10ram, and 130 metastatic ones among 205 lymph nodes with structural changes. If regarding the maximum diameter ~10 mm as a reference of axillary lymph nodes metastasis, low consistency was found with pathological diagnosis criteria （Kappa^O. 184, P= 0. 000）. However the structural changes were highly related to the pathologic findings （Kappa=O. 654, P=0. 000）, and if using it as a reference to predict the preoperative N staging of breast carcinoma, the accuracy was 89.3G. Conclusion Structural change of axillary lymph nodes on MSCT is accurate in predicting lymph nodes metasta- sis, helpful for the preoperative N staging of breast carcinoma.

关 键 词：乳腺癌 腋窝淋巴结转移 N分期 计算机体层成像 

分 类 号：R737.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]