摘要
目的:探讨超声影像对豁免乳腺癌前哨淋巴结活检(SLNB)的诊断价值及影像学特点。方法:选择在医院进行腋窝淋巴结检查的156例患者,所有患者行病理SLNB前均采用超声影像完成腋窝淋巴结检查;将活检结果与超声检查结果进行比较,分析其诊断符合率;绘制受试者工作特征(ROC)曲线,分析超声影像在腋窝淋巴结患者中的诊断效能。结果:在156例腋窝淋巴结检查患者中,经SLNB病理确诊为115例,检出率为73.72%;经超声影像检查确诊阳性109例,与病理SLNB诊断符合率为94.78%。超声影像下腋窝淋巴结阳性患者的淋巴结形态饱满、边缘光滑,可清晰显示皮髓质,皮质增厚,且伴有均匀回声,淋巴门部位可见粗大的血路信号;病理前哨活检阳性与阴性患者淋巴结形态差异无统计学意义;病理SLNB阳性患者与阴性患者间淋巴结内部超声回声和血流分布比较,差异有统计学意义(x2=6.193,x2=7.192;P<0.05)。ROC曲线结果表明,超声影像用于淋巴结患者中ROC曲线下面积(AUC)值为0.852,诊断灵敏度为84.57%,特异度为71.29%。结论:超声影像用于腋窝淋巴结检查中与病理SLNB具有较高的符合率,能够预测腋窝淋巴结的良恶性,豁免SLNB诊断灵敏度较高,可指导临床治疗。
Objective: To investigate the diagnostic value and imaging characteristics of ultrasonography in omitted sentinel lymph node biopsy(SLNB). Methods: A total of 156 patients who underwent axillary lymph node examination were selected as subjects. Ultrasonography was adopted to conduct axillary lymph nodes examination before all patients underwent pathological SLNB. The results of biopsy and the results of ultrasound were compared so as to analyze the diagnostic coincidence rate. The receiver operating characteristics(ROC) curve was drawn to analyze the diagnostic efficiency of ultrasonography in patients with axillary lymph node. Results: The pathologic detection rate of SLNB of 156 patients who underwent axillary lymph nodes examination was 73.72%. 109 cases were confirmed by ultrasonography, and the coincidence rate of that with SLNB was 94.78%. Under ultrasonography, the morphology of lymph node of patients with positive axillary lymph nodes was plump, which edge was smooth, and the medulla could be clearly displayed, and the cortexes of them thickened, which companied with evenly echo. The thick blood path signal of lymph hilum could be found. There was no statistical significance in the morphology of lymph node between patients with positively and negatively pathological SLNB. The differences of internal echo and blood flow distribution between patients with pathologically positive SLNB and patients with pathologically negative SLNB were statistically significant(x~2=4.193, x~2=7.192, P<0.05). The results of receiver operating characteristics(ROC) curve showed that the area under curve(AUC) value of ROC was 0.852 when ultrasonography was used in patients with lymph nodes, and the diagnostic sensitivity and specificity of that were 84.57% and 71.29%, respectively. Conclusion:Ultrasonography has higher coincidence rate with pathologically SLNB when it is used in the examination of axillary lymph node, which can predict the benign and malignant axillary lymph node and can guide clinical treatment.
作者
张迎舟
张宁
马祥敏
赵宁
周新平
ZHANG Ying-zhou;ZHANG Ning;MA Xiang-min(General Surgery Department of Handan Central Hospital,Handan,Hebei 056002,China;不详)
出处
《中国医学装备》
2023年第1期78-81,共4页
China Medical Equipment
基金
河北省医学科学研究课题计划(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”。
