乳腺超声容积成像对乳腺癌淋巴结转移风险的预测价值  

Value of breast ultrasound volume imaging in predicting metastasis of breast cancer

作　　者：雍心愿 曹俊萍 马鑫 付凤丽 王闪[1] 陈正雷[1] YONG Xinyuan;CAO Junping;MA Xin;FU Fengli;WANG Shan;CHEN Zhenglei(Department of Ultrasound Medicine,Zhengzhou Third People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南省郑州市第三人民医院超声医学科,450000

出　　处：《淮海医药》2025年第2期140-143,共4页Journal of Huaihai Medicine

基　　金：河南省医学科技攻关计划联合共建项目(2018020747)。

摘　　要：目的:分析乳腺超声容积成像(ABUS)对乳腺癌病灶转移风险的预测价值。方法:回顾性选取郑州市第三人民医院2021年5月—2023年10月收治的115例乳腺癌患者,依据病灶是否发生腋窝淋巴结转移(ALNM)分为转移组(35例)和未转移组(80例),比较2组患者临床资料,经单因素及Logistic多因素回归方程分析乳腺癌患者发生ALNM的危险因素;通过绘制受试者工作特征(ROC)曲线并观察曲线下面积(AUC)验证ABUS参数对乳腺癌ALNM的预测效能。结果:单因素分析结果显示,转移组年龄、肿瘤最大直径及组织学分级≥Ⅱ级、超声BI-RADS分级≥4级、肿瘤边缘不光滑、内部回声不均匀、肿块内伴微钙化灶、合并汇聚征占比均高于未转移组,肿瘤距乳头位置短于未转移组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,肿瘤最大直径>2 cm、肿瘤距乳头位置<2 cm、肿块内伴微钙化灶、合并汇聚征为乳腺癌ALNM的危险因素。经ROC曲线验证,肿瘤最大直径、肿瘤距乳头位置、肿块内伴微钙化灶、合并汇聚征预测乳腺癌ALNM的AUC分别为0.861、0.855、0.858、0.856,灵敏度分别为81.22%、80.77%、80.45%、79.66%,特异度分别为80.41%、77.46%、78.44%、78.25%。结论:肿瘤最大直径>2cm、肿瘤距乳头位置<2cm、肿块内伴微钙化灶、合并汇聚征为乳腺癌ALNM的危险因素,ABUS或可作为早期识别乳腺癌ALNM风险的无创监测措施。Objective:To analyze the value of breast ultrasound volume imaging(ABUS)in predicting the risk of breast cancer metastasis.Methods:115 breast cancer patients admitted to our hospital from May 2021 to October 2023 were selected in this retrospective study.All the patients were divided into a metastasis group(35 cases)and a non metastasis group(80 cases)according to whether the focus had axillary lymph node metastasis(ALNM).The general data and clinical data of the two groups of patients were compared,and the risk factors of focus metastasis of breast cancer were summarized through single factor analysis and multi factor regression equation analysis.The prediction efficiency of ABUS parameters on ALNM of breast cancer was verified by drawing the ROC of subjects and observing the area under the line(AUC).Results:The results of univariate analysis showed that age,the largest diameter of tumor,proportion of histological grade≥Grade II,proportion of ultrasound BI-RADS grade≥Grade 4,proportion of unsmooth tumor margin,proportion of uneven internal echo,proportion of microcalcification in tumor,and proportion of convergence sign in tumor were higher in the metastatic group than in the non metastatic group,and the location of tumor from nipple was nearer than that in the non metastatic group(P<0.05).Logistic multi factor regression equation analysis showed that the maximum diameter of the tumor(95%CI:1.272~7.933,P=0.023),microcalcification in the tumor(95%CI:1.175~7.886,P=0.016),convergence sign(95%CI:1.365~5.926,P=0.013),and the location of the tumor from the nipple(95%CI:1.221~9.926,P=0.011)were the risk factors for ALNM in breast cancer.The ROC curve showed that the sensitivity of predicting ALNM in breast cancer was 81.22%,80.77%,80.45%,79.66%,and the specificity was 80.41%,77.46%,78.44%,78.25%,respectively.Conclusion:The risk factors of ALNM in breast cancer patients are the largest tumor diameter>2cm,microcalcification in the tumor,convergence sign,and tumor location<2cm from the nipple.ABUS may be a non-invasiv

关 键 词：乳腺肿瘤 乳腺超声容积成像 腋窝淋巴结转移 预测价值 

分 类 号：R737.9[医药卫生—肿瘤]