PET-CT、临床触诊与B超诊断乳腺癌腋窝淋巴结转移的作用评价

EVALUATION OF PET/CT IMAGING, MANUAL PALPATION AND ULTRASONOGRAPHY IN DIAGNOSING AXILLARY LYMPH NODE METASTASES OF BREAST CANCER

目的评价临床触诊、B超及PET-CT在诊断乳腺癌腋窝淋巴结转移的临床价值。方法50例临床确诊的乳腺癌患者分别行PET-CT、B超、临床触诊检查,结合术后病理,比较PET-CT、B超及临床触诊诊断乳腺癌腋窝淋巴结转移的结果。结果PET-CT目测法诊断乳腺癌腋窝淋巴结转移的灵敏度、特异度、准确率及阳性预测值分别为83.3%、66.7%、79.2%及88.2%,B超的灵敏度、特异度、准确率及阳性预测值分别为87.5%、40.0%、73.5%及77.8%,临床触诊的灵敏度、特异度、准确率及阳性预测值分别为69.4%、66.7%、68.8%及86.2%。三种方法对乳腺癌腋窝淋巴结转移的诊断效能无显著性差异(p>0.05)。结论三种方法尚没有足够的敏感性及准确率成为准确诊断乳腺癌腋窝淋巴结状况的方法,但PET-CT的准确率高于B超及临床触诊,PET-CT及B超的灵敏度均明显高于临床触诊。且PET-CT能对乳腺癌的分期提供更多的信息。

Objective To evaluate the value of PET/CT imaging and manual palpation, ultrasonography in diagnosing axillary metastases lymph node of breast cancer. Methods Before definite therapy 50 patients with diagnosing breast cancer underwent 18F - FDG PET - CT imaging, manual palpation and ultrasonography respectively. The results of the histopathology after surgery were used as diagnostic golden standard. The findings of PET - CT imaging, manual palpation and ultrasonography in diagnosing axillary metastases lymph node of breast cancer were compared. Results The sensitivity, specificity, accuracy and positive predictive value obtained by PET -CT were 83.3%, 66.7%, 79. 2% and 88. 2%, respectively, and which were 87.5% ,40.0% ,73. 5% ,77. 8% and 69.4%, 66.7% ,68.8% ,86. 2% with ultrasonography and manual palpation. In the diagnostic ability among the three methods there was no significant difference showed （p 〉0. 05）. Condusions Without enough sensitivity and accuracy, three ways could not become exact means for diagnosing axiUary metastases lymph node of breast cancer, But PET - CT has a higher degree of accuracy than ultrasonography and manual palpation, PET - CT and ultrasonography have a higher degree of sensitivity than manual palpation in diagnosing axiUary metastases lymph node of breast cancer. PET - CT can provide more aspects of in information in breast cancer.