超声、RTE及FNAC对非特殊型浸润性乳腺癌病人腋窝淋巴结状态的诊断价值  

Diagnostic value of ultrasound, RTE, and FNAC for axillary lymph node status in patients with invasive breast cancer of non-special type

作　　者：杜欢 李林 李阳 孙医学[1] DU Huan;LI Lin;LI Yang;SUN Yi-xue(Department of Ultrasound Medicine,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院超声医学科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2023年第12期1726-1729,1733,共5页Journal of Bengbu Medical College

基　　金：蚌埠医学院自然科学研究重点项目(2021byzd066)。

摘　　要：目的:探讨超声(US)、实时组织弹性成像(RTE)及细针穿刺抽吸细胞学(FNAC)诊断非特殊型浸润性乳腺癌(IBC-NST)病人腋窝淋巴结(ALN)状态的价值。方法:共纳入96例女性IBC-NST病人的107个腋窝淋巴结(ALNs),每个淋巴结均行US、RTE和FNAC检查。分别根据目标淋巴结的二维声像图特征对其打分;根据淋巴结弹性图颜色分布情况,以表示弹性硬度较高的红色和黄色占百分比率定义1~4分共4组弹性模式图,根据不同RTE弹性图对其打分;对以上2种评分相加。最终以FNAC或组织病理结果为诊断金标准,构建3种方法的受试者工作特性曲线(ROC),分别计算3种方法诊断的评分界值、曲线下面积(AUC)以及诊断效能。结果:US、RTE、US联合RTE及FNAC诊断IBC-NST病人ALN状态的敏感性和特异性分别为74.6%、77.3%;76.2%、86.4%;88.9%、79.5%以及88.9%、100%。US、RTE及二者联合诊断方法的AUC分别为0.814、0.844和0.915。结论:US和RTE技术对IBC-NST病人的ALN状态显示了较好的诊断价值,二者联合诊断更具优势。FNAC诊断效能最高,但仍有部分假阴性率。Objective To explore the value of ultrasound(US),real-time tissue elastography(RTE)and fine needle aspiration cytology(FNAC)in the diagnosis of axillary lymph node(ALN)status in patients with invasive breast cancer of non-special type(IBC-NST).Methods A total of 107 ALNs from 96 female IBC-NST patients were included in the study,each lymph node underwent US,RTE and FNAC examination.The target lymph nodes were scored according to the characteristics of the 2-dimensional acoustic image of the target lymph nodes.According to the elastography color distribution of the lymph node,the different RTE elastic maps were scored.The above two scores were added up.Finally,the FNAC or histopathological results were used as the diagnostic gold standard,the receiver operator characteristic(ROC)curve of the three methods was constructed,and the boundary value of score,the area under the curve(AUC)and the diagnostic efficacy of the three methods were calculated,respectively.Results The sensitivity and specificity of US,RTE,US combined RTE and FNAC for diagnosing ALN status in IBC-NST patients were 74.6%,77.3%;76.2%,86.4%;88.9%,79.5%,and 88.9%,100%,respectively.The AUC of US,RTE and the combined method were 0.814,0.844 and 0.915,respectively.Conclusions US and RTE techniques show better diagnostic value for ALN status in IBC-NST patients,and the combination of the two was more advantageous.FNAC has the highest diagnostic efficacy,but there is still a partial false-negative rate.

关 键 词：非特殊型浸润性乳腺癌 超声 实时组织弹性成像 细针抽吸细胞学检查 腋窝淋巴结转移 

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