CDU与UE单独及联合应用对乳腺癌腋窝淋巴结良恶性的诊断价值探讨  

The Value of CDU and UE Alone and Combined in the Diagnosis of Breast Cancer and Axillary Lymph Nodes

作　　者：李金凤 韩莉[2] LI Jing-feng;HAN Li(Functional Section,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Gynaecology and Obstetrics,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)功能科,南京210006 [2]南京医科大学附属南京医院(南京市第一医院)妇产科,南京210006

出　　处：《循证医学》2021年第6期341-345,350,共6页The Journal of Evidence-Based Medicine

摘　　要：目的探讨彩色多普勒超声(color Doppler ultrasound,CDU)与超声弹性成像(ultrasound elastography,UE)单独及联合在乳腺癌腋窝淋巴结良恶性诊断中的应用。方法选取2017年1月1日至2019年12月31日在南京医科大学附属南京医院接受治疗的乳腺癌患者80例,均行CDU检查及UE检查,采用受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC)评估两种方法对乳腺癌腋窝淋巴结良恶性的诊断价值。结果术后病理检查结果显示,80例乳腺癌患者中,恶性结节48例,良性结节32例;CDU检查显示,良性结节组患者肿瘤长短径之比(long/short,L/S)明显高于恶性结节组(P<0.05),良性结节组患者彩色多普勒血流成像(color Doppler flow imaging,CDFI)血流特点以无血流型为主,恶性结节组以门型为主(P<0.05);UE显示,良性结节组患者评分以1~2分为主,恶性结节组以3~4分为主(P<0.05);CDU诊断、UE单独诊断及联合诊断腋窝淋巴结性质的AUC值分别为0.703、0.818、0.901。结论CDU与UE联合检查可提高鉴别乳腺癌腋窝淋巴结良恶性质的准确性,降低误诊率,对临床肿瘤诊断具有重要参考价值。Objective To explore the application of color Doppler ultrasound(CDU)and ultrasound elastography(UE)in the diagnosis of breast cancer and axillary lymph nodes.Methods Select 80 cases of breast cancer patients who were treated in Nanjing First Hospital from January 1,2017 to December 31,2019.The CDU and UE were used,and the area under the curve(AUC)of receiver operating characteristic(ROC)was used to evaluate the diagnostic value of the two methods for breast cancer axillary lymph node benign and malignant.Results Postoperative pathological examination showed that of 80 breast cancer patients,48 were malignant nodules and 32 were benign nodules.CDU examination of the two groups of patients showed that the ratio of tumor length to diameter in the benign nodule group was significantly higher than that in the malignant nodule group(P<0.05).Color Doppler flow imaging(CDFI)in the benign nodule group was characterized by no blood flow type,and the malignant nodule group was mainly portal type(P<0.05).Ultrasound elastography showed that patients with benign nodules was divided into main scores from 1 to 2,and malignant nodules was divided into main scores from 3 to 4(P<0.05).The AUC values of CDU diagnosis,UE alone diagnosis and combined diagnosis of axillary lymph node properties were 0.703,0.818 and 0.901,respectively.Conclusions Combined examination of CDU and UE could improve the accuracy of differentiating benign and malignant axillary lymph nodes of breast cancer,reduced the misdiagnosis rate,and had important reference value for clinical tumor diagnosis.

关 键 词：彩色多普勒超声 超声弹性成像 乳腺癌 腋窝淋巴结 良恶性诊断 

分 类 号：R737.9[医药卫生—肿瘤] R730.41[医药卫生—临床医学]