经皮超声造影在浸润性乳腺癌前哨淋巴结转移评估中的应用价值  

Application value of percutaneous contrast-enhanced ultrasound in sentinel lymph node metastasis in invasive breast cancer

作　　者：梅丽丽[1] 曾书娥[1] 袁峰[2] 褚丹[1] MEI Li-li;ZENG Shu-e;YUAN Feng;CHU Dan(Department of Ultrasound,Hubei Cancer Hospital,Wuhan 430070,Hubei,China;Department of Breast Surgery,Hubei Cancer Hospital,Wuhan 430070,Hubei,China)

机构地区：[1]湖北省肿瘤医院超声科,湖北武汉430070 [2]湖北省肿瘤医院乳腺外科,湖北武汉430070

出　　处：《川北医学院学报》2021年第11期1455-1457,1487,共4页Journal of North Sichuan Medical College

基　　金：湖北省卫生健康委员会科研项目(WJ2019F188)。

摘　　要：目的:探讨经皮超声造影(CEUS)对浸润性乳腺癌前哨淋巴结转移的评估价值。方法:回顾性分析行手术治疗的87例浸润性乳腺癌患者临床病理资料及CEUS资料。将CEUS增强模式分为Ⅰ型(均匀增强型)、Ⅱ型(不均匀增强型)、Ⅲ型(微弱或无增强型),对比分析阳性前哨淋巴结(SLN)与阴性SLN的增强模式特征,并评价CEUS增强模式对SLN转移的诊断效能。结果:87例患者中,术前CEUS及手术共检出SLN 114枚,其中病理结果证实31枚(27.19%)为阳性,83例(72.81%)为阴性。阴性SLN与阳性SLN的CEUS增强模式分型比较,差异有统计学意义(P<0.05),阴性SLN以Ⅰ型为主,阳性SLN主要为Ⅱ型,其次为Ⅲ型。以病理结果为金标准,经皮CEUS诊断术前诊断SLN转移的敏感度为87.10%,特异度为91.57%,准确度为90.35%,阳性预测值为79.41%,阴性预测值为95.00%,受试者工作特征曲线(ROC)下面积(AUC)为0.893(95%CI:0.822~0.943)。结论:经皮CEUS在浸润性乳腺癌SLN转移评估中有较高应用价值。Objective:To evaluate the value of percutaneous contrast-enhanced ultrasound(CEUS) in sentinel lymph node metastasis in invasive breast cancer.Methods:The clinicopathological data and CEUS data of 87 patients with invasive breast cancer were retrospectively analyzed.CEUS enhancement mode was divided into type Ⅰ(homogeneous enhancement),type Ⅱ(heterogeneous enhancement) and type Ⅲ(weak or no enhancement).The enhancement mode characteristics of positive SLN and negative SLN were compared and analyzed, and the diagnostic efficacy of CEUS enhancement mode in SLN metastasis was evaluated.Results: 114 SLNs were detected in 87 patients before CEUS and operation, of which 31(27.19%) were positive and 83(72.81%) were negative.There was significant difference in CEUS enhancement pattern classification between negative SLN and positive SLN(P< 0.05).Negative SLN was mainly type Ⅰ,positive SLN was mainly type Ⅱ,followed by type Ⅲ.Taking surgical pathology as the gold standard, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under ROC curve of percutaneous CEUS in the diagnosis of SLN metastasis were 87.10%,91.57%,90.35%,79.41%,95.00% and 0.893(95% CI:0.822~0.943).Conclusion: Percutaneous CEUS is of high value in the evaluation of SLN metastasis in invasive breast cancer.

关 键 词：乳腺肿瘤 淋巴结转移 前哨淋巴结 超声造影 定性诊断 病理 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]