超声诊断乳腺癌腋窝淋巴结转移的临床价值

A clinic value of ultrasonic diagnosis on axillary lymph node metastasis in breast carcinoma

目的：评价超声与临床触诊诊断乳腺癌腋窝淋巴结转移的灵敏度、特异度和准确度。方法：应用双盲法对106例（110侧）行乳腺癌根治术患者的术前触诊、超声检查及术后病理检查进行对比分析。结果：110侧中，病理证实82侧有淋巴结转移，临床触诊与超声检出分别为70侧和78侧，触诊的灵敏度、特异度、诊断符合率分别为68．3％，50．0％，63．6％，超声分别为87．8％，78．6％，85．5％，两组间的灵敏度及诊断符合率差异有统计学意义（P〈0．05或〈0．01），特异度差异无统计学意义（P〉0．05）。结论：超声检查腋窝淋巴结的灵敏度及诊断符合率均高于触诊，可作为诊断腋窝淋巴结转移的常规检查项目。

Objective ： To compare the accuracy of ultrasonography with palpation in the diagnosis of axillary nodal metastasis in breast cancer. Methods：Preoperative ultrasonography and palpation and postoperative histopathology were performed on 110 axillae of 106 patients undergoing radical surgery for breast cancer. Results ：Of the 110 axillae,there were 82 metastatic lymph nodes by pathological examination, 70 by palpation,and 78 by uhrasonography. The sensitivity,specificity,and diagnostic accordance rate （DCR） were 68.3%, 50. 0% and 63.6% in palpation,and 87.8%, 78.6% and 85.5% in ultrasonography;there were significant differences in the sensitivity and DCR between the palpation and ultrasonography （P〈0.05-0.01）. Conclusion ： Ultrasonic examination has the advantages of high sensitivity and DCR over the palpation,and may be served as a routine examination in the diagnosis of axillary nodal metastasis in breast cancer.