【摘要】 目的腋窝淋巴结性质是影响乳腺癌预后的重要因素,也是临床选择治疗方式的重要依据。通过常规超声、超声弹性成像及二者联合的方法探讨诊断乳腺癌患者反应性淋巴结和转移性淋巴结的临床价值。方法选择2015-10-01-2016-04-30山东大学附属山东省肿瘤医院乳腺外科42例乳腺癌患者,共66个同侧腋窝淋巴结,应用常规超声、超声弹性成像评分法检查,与手术病理结果对照。结果在66个淋巴结中,反应性淋巴结34个,转移性淋巴结32个。常规超声反应性淋巴结得分1.12±0.98,转移性淋巴结得分2.53±1.37,差异有统计学意义,P<0.05。超声弹性成像反应性淋巴结得分2.21±0.64,转移性淋巴结得分3.13±0.66,差异有统计学意义,P<0.05。常规超声、超声弹性成像及二者联合的灵敏度分别为71.9%、84.4%和87.5%,特异度分别为76.5%、67.6%和52.9%,准确度分别为57.0%、58.1%和69.7%,三者受试者工作特征(receiver operating characteristic curve,ROC)曲线下面积分别为0.783、0.815和0.932,联合应用与常规超声比较差异有统计学意义,Z=2.28,P<0.05;联合应用与弹性成像比较,差异无统计学意义,Z=1.95,P>0.05;常规超声与弹性成像比较差异无统计学意义,Z=0.41,P>0.05。结论常规超声联合超声弹性成像有助于提高乳腺癌腋窝淋巴结性质的诊断效能。更多还原

【Abstract】 OBJECTIVE The status of axillary lymph node is important on the prognosis,and is a important factor for clinical choice of treatment in breast cancer.This study was to explore the value of conventional ultrasound,ultrasound elastography and combined in differentiating reactive and metastatic axillary lymph nodes in breast cancer.METHODS A total of 66 lymph nodes from 42 patients with breast cancer were examined by conventional ultrasound and ultrasound elastography from October 1,2015 to April 30,2016.Conventional ultrasound scores were determined according to the4criteria:short diameter,long to short-axis diameter radio,cortical thickening and hilum.Ultrasound elastography scores were given according to the performance of high-elasticity areas in the lymph nodes.RESULTS Of a total of 66 axillary lymph nodes,34 were reactive and 32 were metastatic.The conventional ultrasound sores for metastatic lymph nodes(2.53±1.37)was significantly higher than the score for reactive lymph nodes(1.12±0.98).There was significant difference between conventional ultrasound and ultrasound elastography.Conventional ultrasound showed 71.9%sensitivity,76.5% specificity and 57.0% accuracy.Ultrasound elastography showed 84.4% sensitivity,67.6% specificity and58.1% accuracy.Combination of conventional ultrasound and ultrasound elastography showed 87.5% sensitivity,52.9%specificity and 69.7% accuracy.The areas under curve of ROC for conventional ultrasound,ultrasound elastography and the combined method were 0.783,0.815 and 0.932,respectively.The combined method has significant difference compared to conventional ultrasound(Z=2.28,P<0.05).The combined method compared with ultrasound elastography had no significant difference(Z=1.95,P>0.05).There was no significant difference between conventional ultrasound and ultrasound elastography(Z=0.41,P>0.05).CONCLUSION Combined conventional ultrasound and ultrasound elastography can improve the diagnostic value of axillary lymph nodes properties in breast cancer.更多还原