不同部位注射超声造影剂诊断乳腺癌前哨淋巴结的临床应用  

Clinical study of different parts of ultrasound contrast agent in the diagnosis of sentinel lymph node in breast cancer

作　　者：杨少玲 唐克强[2] 陶均佳 敖洪峰 万爱红 沈智勇[4] 

机构地区：[1]上海市奉贤区中心医院心血管超声科,上海201499 [2]上海市松江区中心医院ICU,上海201600 [3]上海市奉贤区中心医院病理科,上海201499 [4]南通市肿瘤医院影像科,江苏南通226361

出　　处：《临床和实验医学杂志》2016年第18期1773-1776,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市卫生技术监督委员会课题(编号:20134054)

摘　　要：目的探讨不同部位注射超声造影剂诊断乳腺癌前哨淋巴结的临床价值。方法选择于2013年1月至2015年7月收治的98例乳腺癌患者为研究对象,所有患者均经乳晕周围皮下、肿瘤内部及肘静脉分别注射Sonovue造影剂,行亚甲蓝染色及病理检验。以亚甲蓝染色及病理组织学为金标准,按临床诊断性试验的评价标准进行评价。观察并分别记录SLN增强个数、开始增强时间(AT)、达峰时间(TP)。结果所有患者经亚甲蓝染色和术后病理结果证实,共检出SLN 109枚。与病理检测结果比较,经乳晕周围皮下超声造影检出率为90.10%,准确度90.11%,敏感度96.00%,特异度62.50%;肿瘤内部超声造影检出率为76.15%,准确度84.34%,敏感度86.11%,特异度72.73%;经静脉检出率为29.36%,准确度46.88%,敏感度42.86%,特异度75.00%。三组比较SLN检测个数差异具有统计学意义(χ2=9.763,P=0.008),其中经乳晕周围皮下最高,经静脉最低。而经乳晕周围皮下和经肿瘤内部AT和TP时间均高于经静脉(P<0.05或P<0.01)。结论经乳晕周围皮下注射超声造影剂,SLN检出率高,具有较好的临床实用价值,有效改善患者生活质量,值得推广应用。Objective This study aims to investigate the clinical application of different parts of the ultrasound contrast agent in the diagnosis of sentinel lymph node in breast cancer. Methods 98 cases from January 2013 and July 2015 were selected into the present study. All patients injected SonoVue contrast agent in the areola around subcutaneous, tumor and venous respectively. As the gold standard, they were tested by methylene blue staining and pathological examination. It was analyzed according to the clinical diagnostic test evaluation criteria. The number of SLN enhancement, starting time （AT） , peaking time （TP） were observed and recorded. Results All the patients were confirmed by methylene blue staining and postoperative pathological results, and 109 of SLN were detected. Compared with the pathological examination results, the detection rate was 90. 10% by around the areola subcutaneous contrast enhanced ultrasound, following the accuracy of 90. 11% , the sensitivity of 96. 00% , the specificity of 62. 50% . The detection rate was 76. 15% by tumor contrast enhanced ultrasound, following the accuracy of 84. 34% , the sensitivity of 86. 11 % , the specificity of 72. 73% . The detection rate was 29.36% by intravenous contrast enhanced ultrasound, following the accuracy 46. 88% , the sensitivity of 42. 86% , the specificity of 75. 00% . The three groups have statistical signifi-cance difference comparing SLN detection number （ χ^2= 9 . 763 , P = 0. 0 0 8 ） , and the lowest of intravenous detection. T h e time of AT and TP in the around the areola subcutaneous contrast enhanced ultrasound and tumor contrast enhanced ultrasound was higher than that of in the intra-venous contrast enhanced ultrasound （ P 〈0.05 orP 〈0.01）. Conclusion It has higher SLN detection rate in the around the areola subcuta-neous contrast enhanced ultrasound injection of ultrasound contrast agent. It has a good clinical practical value, which effectively improves the life quality of patients, and is worth p

关 键 词：乳腺癌 超声造影剂 前哨淋巴结 乳晕周围皮下 检出率 

分 类 号：R737.9[医药卫生—肿瘤]