超声引导细针穿刺结果与乳腺癌腋下转移性淋巴结数目的相关性研究  

The Study of the Correlation between the Results of Ultrasound-guided Aspiration and Axillary Lymph Node Load in Breast Cancer

作　　者：乐坚[1] 周世崇[1] 胡娜[1] 高毅[1] 陈敏[1] 常才[1] 

机构地区：[1]复旦大学附属肿瘤医院超声医学科复旦大学上海医学院肿瘤学系,上海市200032

出　　处：《中国超声医学杂志》2017年第12期1067-1070,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.81371575;No.81627804)

摘　　要：目的研究超声引导下细针穿刺(US-FNA)对乳腺癌腋下淋巴结的诊断价值,并且探讨穿刺结果与腋下转移性淋巴结数目之间的相关性。方法回顾性分析我院超声引导下腋下淋巴结细针穿刺255例浸润性乳腺癌病例,以前哨淋巴结活检(SLNB)或腋下淋巴结清扫术(ALND)后病理作为金标准,评估US-FNA对乳腺癌腋下淋巴结转移的诊断价值,并且探讨US-FNA结果与腋下转移性淋巴结数目之间的相关性。结果 US-FNA诊断浸润性乳腺癌腋下淋巴结转移的灵敏度81%、特异度98%、阳性预测值97%、阴性预测值84%、准确度89%。129例腋下淋巴结有转移的病例中,105例US-FNA结果为真阳性,避免了前哨淋巴结活检手术。105例细针穿刺结果真阳性组[US-FNA(+)组]与24例穿刺结果假阴性组[US-FNA(-)组]相比,腋下淋巴结转移个数明显增多[(5.7±5.0)枚vs(2.2±2.0)枚],两组间腋下淋巴结转移数目差异具有显著统计学意义(P<0.05)。结论超声引导US-FNA可以有效减少前哨淋巴结活检手术的数量。US-FNA结果与腋下淋巴结肿瘤负荷相关联。Objective To investigate the value of ultrasound-guided fine needle aspiration （US-FNA） in the diag- nosis of axillary lymph nodes in breast cancer, and to evaluate the correlation between the puncture results and the number of axillary metastatic lymph nodes. Methods 255 cases of invasive breast cancer were enrolled between in our hospital. All of cases was received US-FNA. With the pathology of sentinel lymph node biopsy （SLNB）or axillary lymph node dissection （ALND） as a gold standard, the diagnostic value of US-FNA in axillary lymph nodes of breast cancer and the correlation between the results of puncture and axillary lymph nodes were evaluated. Results The Sensitivity, specificity, positive predictive value, negative predictive value, accuracy respectively of FNA were 81%, 98% ,97% ,84% ,89%. In 129 cases of axillary lymph node metastasis, 105 cases was US-FNA true positive and the sentinel lymph node biopsy was avoided. The number of axillary lymph node metastasis in 105 patients with US-FNA （＋） was significantly increased compared with US-FNA （-） group of 24 patients （5.7±5.0 vs 2.2±2.0, P〈 0.05）. Conclusions US-FNA can effectively reduce the number of SLNB. The results of US-FNA were associated with tumor load in axillary lymph nodes of invasive breast cancer.

关 键 词：超声检查 淋巴结 乳腺癌 细针活组织检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]