常规超声联合自动乳腺全容积成像预测乳腺浸润性导管癌腋窝淋巴结转移的临床价值  

Value of conventional ultrasound combined with automated breast volume scanner in predicting axillary lymph node metastasis in invasive ductal carcinoma

作　　者：李雅婷[1] 王丹丹 杨斌[1] 顾军[3] 徐佳玮 徐超丽 张丽娟[4] 孙晖 Li Yating;Wang Dandan;Yang Bin;Gu Jun;Xu Jiawei;Xu Chaoli;Zhang Lijuan;Sun Hui(Department of Ultrasound,Jinling Clinical Medical College(General Hospital of Eastern Theater Command),Nanjing Medical University,Nanjing 210002,China;Department of Ultrasound,Jinling Hospital(General Hospital of Eastern Theater Command),Medical School of Nanjing University,Nanjing 210002,China;Department of General Surgery,Jinling Clinical Medical College(General Hospital of Eastern Theater Command),Nanjing Medical University,Nanjing 210002,China;Department of Founction,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210002,China)

机构地区：[1]南京医科大学附属金陵临床医学院(东部战区总医院)超声诊断科,南京210002 [2]南京大学医学院附属金陵医院(东部战区总医院)超声诊断科,南京210002 [3]南京医科大学附属金陵临床医学院(东部战区总医院)普通外科,南京210002 [4]南京医科大学第四附属医院功能科,南京210002

出　　处：《中华超声影像学杂志》2022年第6期525-531,共7页Chinese Journal of Ultrasonography

摘　　要：目的探讨常规超声联合自动乳腺全容积成像(ABVS)预测乳腺浸润性导管癌患者发生腋窝淋巴结转移(ALNM)的临床价值。方法回顾性分析2014年1月至2020年12月东部战区总医院乳腺外科收治的96例女性乳腺癌患者(96个肿块),所有患者治疗前均行常规超声和ABVS检查,依据术后病理结果将乳腺癌患者分为有腋窝淋巴结转移(ALNM)组(53例)和无腋窝淋巴结转移(N-ALNM)组(43例),比较两组间各项超声参数的差异,并行二元Logistic回归分析,确定乳腺癌ALNM的独立预测因素。绘制ROC曲线以评估其诊断效能。结果相较于N-ALNM组,ALNM组具有肿瘤最长径更长、边界不清楚、内部回声分布不均匀、血流分级Ⅱ~Ⅲ级、有汇聚征的特点,差异有统计学意义(均P<0.05)。行二元Logistic回归分析显示,肿瘤最长径、内部回声不均匀、有汇聚征是乳腺癌ALNM的独立预测因素(OR=1.051、4.055、3.493,均P<0.05);3个参数串联联合预测乳腺癌ALNM的ROC曲线下面积为0.752(0.653~0.834),敏感性为54.7%,特异性为83.7%。结论超声测得的肿瘤最长径、内部回声不均匀、有汇聚征是乳腺癌患者ALNM的独立预测因素,三者联合可为乳腺癌患者ALNM的评估和临床治疗方案的制定提供影像学依据。Objective To investigate the clinical value of conventional ultrasound combined with automated breast volume scanner(ABVS)in predicting axillary lymph node metastasis(ALNM)of patients with invasive ductal carcinoma.Methods A retrospective analysis was performed in 96 patients in the General Hospital of Eastern Theater Command from January 2014 to December 2020.All patients were examined by conventional ultrasound and ABVS before treatment.The patients were divided into the ALNM group and non-axillary lymph node metastasis(N-ALNM)group according to the postoperative pathological results.The differences of ultrasound parameters between the two groups were compared,and Logistic regression was used to analyze the independent predictive factors of ALNM.The ROC curve was plotted to evaluate the diagnostic efficacy for ALNM.Results Compared with the N-ALNM group,the ALNM group had the characteristics of larger long diameters,unclear boundary,uneven internal echo,Adler blood flow gradeⅡ-Ⅲand retraction phenomenon(all P<0.05).Logistic regression analysis showed that the long diameter,uneven internal echo,and retraction phenomenon were independent predictors of ALNM(OR=1.051,4.055,3.493,all P<0.05).The area under curve of ALNM was 0.752(0.653-0.834),the sensitivity and specificity were 54.7%and 83.7%,respectively.Conclusions The long diameter,uneven internal echo,and retraction phenomenon measured by conventional ultrasound and ABVS are independent predictors of ALNM.The combination of the three can provide imaging references for the evaluation of ALNM of breast cancer.

关 键 词：超声检查 乳腺癌 自动全容积成像 汇聚征 腋窝淋巴结转移 

分 类 号：R737.9[医药卫生—肿瘤]