乳腺癌前哨淋巴结超声影像准确性多因素分析与豁免前哨淋巴结活检术的可行性研究  

Multivariate analysis of the accuracy of ultrasound imaging on sentinel lymph node in breast cancer and the feasibility of that with the exempt sentinel lymph node biopsy

作　　者：张迎舟[1] 张宁[2] 刘艳超 周新平[3] ZHANG Ying-zhou;ZHANG Ning;LIU Yanchao(The Second Department of Breast Surgery,Handan Central Hospital,Handan 056002,China;不详)

机构地区：[1]邯郸市中心医院乳腺外二科,河北邯郸056002 [2]邯郸市中心医院超声科,河北邯郸056002 [3]邯郸市中心医院乳腺外一科,河北邯郸056002

出　　处：《中国医学装备》2023年第8期61-65,共5页China Medical Equipment

基　　金：河北省卫生健康委科研基金(20211319)“乳腺癌前哨淋巴结超声影像准确性多因素分析与豁免前哨淋巴结活检术可行性研究”。

摘　　要：目的:探讨乳腺癌前哨淋巴结超声影像诊断准确性影响多因素Logistic分析及与豁免前哨淋巴结(SLN)活检术的可行性。方法:选择在医院行腋窝淋巴结检查的118例疑似乳腺癌患者,所有患者均行超声影像检查后行病理SLN活检术,并根据诊断结果将其分为符合组(10例,假阴性率<10.0%)和不符合组(108例,假阴性率≥10.0%),分析超声影像检查在乳腺癌SLN中的诊断准确率,对可能影响诊断准确率的因素进行单因素及多因素Logistic分析。结果:在118例乳腺癌患者中,经SLN诊断阳性12例,确诊率为10.17%;超声影像检查诊断阳性18例,诊断符合率为91.53%。超声影像检查在乳腺癌SLN中诊断灵敏度为83.33%,特异度为92.45%,假阴性率为28.57%;单因素及多因素Logistic分析结果表明:超声影像在乳腺癌SLN诊断准确率与患者年龄、肿瘤大小及乳腺患侧部位无统计意义;病灶强化特点、肿块形状、淋巴结(LN)长径、LN短径、非肿块样强化内部强化特征、肿块样强化特征以及肿块边缘是超声影像在乳腺癌SLN诊断准确率的影响因素(OR=7.892,OR=6.791,OR=5.457,OR=6.632,OR=4.313,OR=5.412,OR=6.323;P<0.05)。结论:超声影像在乳腺癌SLN的诊断中与SLN活检术符合率较高,因此在临床诊断中具有较高的应用价值。Objective:To investigate the feasibilities that diagnostic accuracy of ultrasound imaging on sentinel lymph node(SLN)in breast cancer affected multivariate Logistic analysis and the exempt sentinel lymph node biopsy(SLNB).Methods:A total of 118 patients with suspected breast cancer were selected.All patients underwent pathological SLNB after underwent ultrasound imaging examination.All of them were divided into coincidence group(10 cases,false negative rate<10.0%)and non-coincidence group(108 cases,false negative rate≥10.0%)according to diagnostic results.The diagnostic accuracy rate of ultrasound imaging examination was analyzed in the SLN of breast cancer,and the factors that might affect diagnostic accuracy rate were further analyzed by single factor and multivariate Logistic analysis.Results:There were 12 cases were positive in 118 patients with breast cancer as SLN diagnosis,and the diagnosis rate was 10.17%,and there were 18 cases were positive as ultrasound imaging examination,and the diagnostic coincidence rate was 91.53%.The diagnostic sensitivity,specificity and false negative rate of ultrasound imaging examination were respectively 83.33%,92.45% and 28.57%in the breast cancer SLN.The results of single factor and multivariate Logistic analysis showed that there were not significant difference between the diagnostic accuracy rate of ultrasound imaging in the breast cancer SLN and the age,tumor size,and the location of the affected side of the breast.The characteristics of the lesion enhancement,the tumor shape,the long diameter of lymph node(LN),the LN short diameter,the internal enhancement features of non-mass-like enhancement,the features of masslike enhancement and the edge of the mass were respectively the influencing factors of the accuracy rate of ultrasound imaging in diagnosing breast cancer SLN(OR=7.892,OR=6.791,OR=5.457,OR=6.632,OR=4.313,OR=5.412,OR=6.323,P<0.05).Conclusion:Ultrasound imaging has higher diagnostic consistence rate with the SLNB in the diagnosis of breast cancer SLN,therefore

关 键 词：超声影像 乳腺癌 豁免前哨淋巴结(SLN)活检术 诊断准确率 多因素LOGISTIC分析 符合率 

分 类 号：R737.9[医药卫生—肿瘤]