彩色多普勒超声对乳腺癌前哨淋巴结微转移的诊断价值  

DIAGNOSTIC VALUE OF COLOR DOPPLERULTRASOUND FOR SENTINEL LYMPH NODES MICROMETASTASES OF BREAST CANCER

作　　者：练斌[1] 覃庆洪[1] 杨伟萍[2] 丁战玲[2] 韦长元[1] 叶新青[3] Lian Bin Qin Qinghong Yang Weiping Ding Zhanling Wei Changyuan Ye Xinqing(Department of Breast Surgery,the Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021 China)

机构地区：[1]广西医科大学附属肿瘤医院乳腺外科,南宁530021 [2]广西医科大学附属肿瘤医院B超室,南宁530021 [3]广西医科大学附属肿瘤医院病理科,南宁530021

出　　处：《广西医科大学学报》2016年第5期783-786,共4页Journal of Guangxi Medical University

基　　金：广西壮族自治区卫生厅重点课题资助项目(No.重2012088);广西壮族自治区科技厅科学基金资助项目(No.桂科青0339032)

摘　　要：目的:评价彩色多普勒超声对乳腺癌前哨淋巴结(SLN)微转移的诊断价值。方法:回顾性分析行乳房单纯切除/保乳+SLN活检术的患者167例,术后对139例术中快速冷冻病理检查为阴性的314枚SLN行病理超薄切片和免疫组化检查,结合患者彩超结果,分析彩色多普勒超声对存在乳腺癌微转移的SLN诊断的准确性及声像学特点。结果:有淋巴结微转移的19例患者的彩色多普勒成像中,15例有丰富的形态学改变或血流显示,且有12例获得动脉血流频谱。淋巴结微转移组淋巴结长短径比(L/S)为1.43±0.31,周边血流峰值流速(Vmax)为(18.29±2.70)cm/s,阻力指数(RI)为0.72±0.13。SLN微转移组淋巴结的L/S明显小于正常淋巴结组(P=0.024),Vmax、RI均高于正常淋巴结组(均P<0.05),但与宏转移组相比,差异无统计学意义(P>0.05)。结论:彩色多普勒超声对存在微转移的乳腺癌淋巴结有可观的诊断指征。结合示踪剂引导SLN活检,可提高SLN的发现率及活检率。Objective To evaluate the clinical value of color Doppler ultrasound in the diagnosis of breast cancer micrometastases in sentinel lymph nodes （SLN）. Methods： 167 patients underwent breast simple mammectomy or breast-conserving surgery plus SLN biopsy were analyzed retrospectively. 314 SLN tissue from 139 negative cases were examined by HE staining and immunohistochemical assay and ultrasonogra-phy. The diagnostic accuracy and characteristics of color Doppler ultrasound for patients with breast cancer micrometastases in SLN were analyzed combined with the results of ultrasonography. Results： Among 19 cases with SLN micrometastases,under color Doppler evaluation,15 cases showed abundant morphological changes and blood flow changes, and arterial flow spectrums were obtained from 12 patients. The L/Sratio of SLN,peripheral blood flow peak velocity （Vmax） and resistance index （RI） in the SLN microme- tastases group were 1. 43± 0. 31,1 8. 29 ± 2. 70 cm/s and 0. 72± 0. 1 3 ,respectively. The L/S ratio of SLN was significantly lower,while Vmax and RI were notably higher in the micrometastases group than in the normal group （ P 〈 0.05）. However, it showed no significant difference between the micrometastases group and the macrometastases group in the above indexes （ P 〉0. 05）. Conclusion： Color Doppler ultra-sound had a clinical value for the diagnosis of breast cancer micrometastasis in SLN. SLtracer can improve the detection rate of SLN.

关 键 词：前哨淋巴结 彩色多普勒超声 微转移 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]