【摘要】 目的：探讨常规超声联合超声造影（contrast-enhanced ultrasound,CEUS）特征在预测乳腺癌术后复发转移情况中的应用价值。方法：纳入2016年1月—2017年12月在南京医科大学第一附属医院行乳腺癌手术且经病理学检查证实为乳腺癌的139例女性患者作为研究对象，分析这些患者5年内复发转移情况，其中未复发转移组126例，复发转移组13例（复发患者3例，转移患者10例），采用单因素及多因素logistic回归分析两组患者常规超声及CEUS特征与乳腺癌术后复发转移情况的相关性，建立常规超声联合CEUS模型并分析其诊断效能。结果：单因素分析显示，造影剂分布特征（不均匀）、造影后病灶边界（不清晰）、生长方位（垂直）、淋巴结血供（非淋巴门型）差异有统计学意义；logistic回归分析显示，造影剂分布特征（OR=5.686,P=0.047）、生长方位（OR=5.190,P=0.015）以及淋巴结血供（OR=6.725,P=0.006）是术后复发转移的独立危险因素。通过筛选出的危险因素构建常规超声联合CEUS模型。造影剂分布特征、生长方位、淋巴结血供及常规超声联合CEUS模型的受试者工作特征（receiver operating characteristic,ROC）曲线的曲线下面积分别为0.677、0.677、0.685、0.841，较单因素模型有较高的准确度。结论：本研究建立的常规超声联合CEUS模型在预测乳腺癌术后复发转移方面具有一定的临床价值。可为乳腺外科医师治疗前针对具有复发风险患者改进治疗方案提供参考依据。更多还原

【Abstract】 Objective: To investigate the value of characteristics of conventional ultrasound combined with contrast-enhanced ultrasound(CEUS) in predicting the recurrence or metastasis of postoperative breast cancer patients. Methods: A total of 139 patients with breast cancer in Nanjing Medical University First Hospital confirmed by pathology and subsequently underwent surgical resection from January 2016 to December 2017 were selected in this study, and the recurrence or metastasis of these patients within five years were analyzed, including 126 patients without recurrence or metastasis and 13 patients with recurrence or metastasis(3 patients with recurrence and 10 patients with metastasis). The correlation between the characteristics of conventional ultrasound combined with CEUS and the recurrence or metastasis of postoperative breast cancer in the two groups was determined by univariate analyses. Logistic regression was used to screen out the risk factors and establish a model to analyze its diagnostic efficacy.Results: Univariate analysis showed that the uniformity of enhancement(uneven), lesion edges after enhancement(blurry), tumor orientation(vertical) and lymph node blood flow(non-lymphoid portal type) were correlated with the recurrence or metastasis of postoperative breast cancer. Multivariable logistic regression showed that the uniformity of enhancement(OR=5.686, P=0.047),tumor orientation(OR=5.190, P=0.015) and lymph node blood flow(OR=6.725, P=0.006) were independent risk factors for recurrence or metastasis in postoperative breast cancer patients. Logistic regression analysis was used to screen out the risk factors and establish conventional ultrasound combined with CEUS model. The area under the receiver operating characteristic(ROC) curve for uniformity of enhancement, tumor orientation, lymph node blood flow and conventional ultrasound combined with CEUS model were 0.677, 0.677, 0.685 and 0.841 respectively. Conclusion: The conventional ultrasound combined with CEUS model established in this study has certain application value in predicting the recurrence or metastasis of postoperative breast cancer. It provides the reference basis for breast surgeons to improve the treatment plan for patients with recurrence risk before treatment.更多还原