超声造影征象结合血清学指标对40岁以下乳腺癌患者发生腋窝淋巴结转移的预测价值  

Predictive value of contrast-enhanced ultrasound combined with serological markers in the diagnosis of axillary lymph node metastasis in breast cancer patients under 40 years

作　　者：王月[1] Wang Yue(Ultrasound Department,Dalian No.3 People's Hospital,Dalian Liaoning 116091,China)

机构地区：[1]大连市第三人民医院超声科,辽宁大连116091

出　　处：《保健医学研究与实践》2022年第10期78-82,共5页Health Medicine Research and Practice

摘　　要：目的 探讨超声造影征象结合血清学指标对40岁以下乳腺癌患者发生腋窝淋巴结转移的预测价值,以期为临床诊断提供参考。方法 本研究选取2017年1月—2021年1月在大连市第三人民医院接受手术治疗的157例乳腺癌患者作为研究对象。根据年龄分为年龄<40岁组和年龄≥40岁组。年龄<40岁组患者按照是否有淋巴结转移分为转移组和未转移组。收集患者的相关临床资料,包括超声造影参数和组织多肽特异性抗原(TPS)、胸苷激酶1(TK1)、血管内皮生长因子(VEGF)水平等。采用多因素Logistic回归对上述指标与腋窝淋巴结转移的相关性进行分析。结果 不同年龄组患者的造影灌注缺损征象和峰值强度比较,差异均有统计学意义(P<0.05)。转移组与未转移组患者的淋巴结边缘有无放射状增强、淋巴结周边声晕、淋巴结灌注顺序、淋巴结径线有无扩大、淋巴结血流分级、淋巴结边缘有无放射状增强、淋巴结纵横比、淋巴结最大皮质厚度和原发灶相对曲线下面积比较,差异均有统计学意义(P<0.05),且转移组与未转移组患者的TPS、TK1水平比较,差异也有统计学意义(P<0.05)。Logistic回归分析结果显示:淋巴结边缘有无放射状增强、淋巴结径线有无扩大、淋巴结最大皮质厚度和TPS、TK1水平均是影响诊断40岁以下乳腺癌患者发生腋窝淋巴结转移的独立因素(P<0.05)。结论 相较于40岁以上患者,40岁以下乳腺癌患者超声造影检查征象中峰值更高,也更容易发生灌注缺损。同时,超声造影征象中淋巴结边缘有无放射状增强、淋巴结径线有无扩大、淋巴结最大皮质厚度和TPS、TK1水平可对乳腺癌患者是否发生腋窝淋巴结转移进行预测,对临床诊断和治疗具有指导意义。Objective To investigate the predictive value of contrast-enhanced ultrasound combined with serological markers for axillary lymph node metastasis in breast cancer patients under 40 years, so as to provide a reference for clinical diagnosis. Methods A total of 157 patients with breast cancer who received surgical treatment in the Dalian No.3 People’s Hospital from January 2017 to January 2021 were selected as the study subjects. They were assigned to the age <40 years group and age ≥40 years group according to age. Patients aged <40 years were assigned to the metastatic and non-metastatic groups according to the presence or absence of lymph node metastasis. Relevant clinical data of patients were collected, including contrast-enhanced ultrasound parameters and tissue polypeptide specific antigen(TPS), thymidine kinase 1(TK1), and vascular endothelial growth factor(VEGF) levels. Multivariate logistic regression analysis was employed to analyze the correlation between the above parameters and axillary lymph node metastasis. Results Significant differences in angiographic perfusion defect signs and peak intensity were observed among different aye groups(P<0.05). There were significant differences in lymph node rim enhancement, acoustic halo around lymph nodes, lymph node perfusion order, lymph node diameter enlargement, lymph node blood flow grade, lymph node enhancement pattern, lymph node aspect ratio, maximum cortical thickness of lymph nodes, and relative area under the curve of the primary tumor between the metastatic group and the non-metastatic group(P<0.05). Significant differences in TPS and TK1 levels were also observed between the metastatic group and the non-metastatic group(P<0.05). Logistic regression analysis showed that lymph node enhancement, lymph node enlargement, maximum cortical thickness of lymph nodes, and TPS and TK1 levels were all independent factors affecting the diagnosis of axillary lymph node metastasis in breast cancer patients under 40 years(P <0.05). Conclusion Compared with pati

关 键 词：乳腺癌 腋窝淋巴结 超声造影 组织多肽特异性抗原 胸苷激酶1 

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]