三阴性乳腺癌超声表现及其腋下淋巴结转移的相关危险因素  

Ultrasound signs of triple-negative breast cancer and its risk factors of axillary lymph node metastasis

作　　者：段彤彤 李晓琴[1] 范光磊[2] 施燕芸[1] Duan Tongtong;Li Xiaoqin;Fan Guanglei;Shi Yanyun(Department of Ultrasound,the Affiliated Hospital of Nanjing Medical University,Changzhou No.2 People's Hospital,Changzhou 213000,China;Department of Nuclear Medicine,the Affiliated Hospital of Nanjing Medical University,Changzhou No.2 People's Hospital,Changzhou 213000,China)

机构地区：[1]南京医科大学附属常州市第二人民医院超声科,213000 [2]南京医科大学附属常州市第二人民医院核医学科,213000

出　　处：《中华医学超声杂志（电子版）》2021年第4期381-385,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨三阴性乳腺癌(TNBC)超声征象、临床病理特征及腋下淋巴结转移的相关危险因素。方法回顾性分析2016年3月至2020年5月常州市第二人民医院收治的诊断为TNBC的105例女性患者的病例资料。所有病例均为单侧单发病灶,术前均行常规乳腺超声检查。根据病理结果,分为腋下淋巴结转移(LNM)组和腋下淋巴结未转移(NLNM)组。比较2组TNBC病灶的超声征象(如肿瘤直径、纵横比、形状、边缘、回声、内部有无血流、有无钙化等)及临床病理特征[如年龄、绝经状态、体质量指数(BMI)、组织学分级及病理类型等]的差异,探讨TNBC腋下淋巴结转移的相关危险因素。结果共纳入105例女性TNBC患者,其中LNM组38例,NLNM组67例,年龄25-88(52±12)岁。2组TNBC患者间超声表现,包括肿瘤直径、形态、纵横比、边缘、内部回声、血流、钙化等差异均无统计学意义(均P>0.05)。2组临床病理特征中组织学分级、BMI差异均有统计学意义(均P<0.05)。LNM组肿瘤中高组织学分级(Ⅱ-Ⅲ、Ⅲ级)、BMI<25 kg/m^(2)占比均高于NLNM组(χ^(2)=4.056、5.244,均P<0.05)。二元Logistic回归分析,BMI<25 kg/m^(2)是TNBC腋下淋巴结转移的危险因素(OR=0.360,P=0.024)。2组患者在年龄、绝经状态及病理类型方面差异均无统计学意义(均P>0.05)。结论未发现TNBC超声征象对腋下淋巴结转移有预测价值。BMI<25 kg/m^(2)对判断TNBC腋下淋巴结转移有提示作用。Objective To investigate ultrasound signs and clinicopathological characteristics of triple negative breast cancer(TNBC)and its risk factors of axillary lymph node metastasis.Methods The clinical data of 105 female patients diagnosed with TNBC and admitted to Changzhou Second People's Hospital from March 2016 to May 2020 were retrospectively analyzed.All cases were single-sided breast cancer with only one lump and underwent routine ultrasound examination before operation.According to pathological results,the patients were divided into anaxillary lymph node metastasis(LNM)group and a non-lymph node metastasis(NLNM)group.Ultrasound signs(such as tumor diameter,aspect ratio,shape,margin,echo,internal blood flow,and calcification)and clinicopathological characteristics(such as age,menopausal status,body mass index[BMI],histological grade and pathological type)of the two groups were compared to identify the factors that affect axillarylymph node metastasis in TNBC patients.Results A total of 105 female TNBC patients were enrolled,including 38 cases in the LNM group and 67 cases in the NLNM group,aged 25 to 88(52±12)years.There were no significant differences in ultrasound signs of the two groups,including tumor diameter,form,aspect ratio,margin,echo,blood flow,and calcification(P>0.05 for all).The histological grade and BMI were statistically different between the two groups(P<0.05 for both).The proportion of patients with high histological grade(gradesⅡ-ⅢandⅢ)and a BMI<25 kg/m^(2) in the LNM group were significantly higher than those in the NLNM group(χ^(2)=4.056,5.244,P<0.05 for both).Binary logistic regression analysis showed that BMI<25 kg/m^(2) was a risk factor affecting axillary lymph node metastasis of TNBC patients(OR=0.360,P=0.024).There was no statistical difference between the two groups in age,menopausal status,or pathological type(P>0.05 for all).Conclusion There is no predictive value of TNBC ultrasound signs in axillary lymph node metastasis.BMI<25 kg/m^(2) are helpful for judging axillary lymp

关 键 词：三阴性乳腺癌 超声检查 淋巴结转移 临床病理特征 

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]