乳腺癌腋窝淋巴结的乳腺X线摄影评价

Mammography in Diagnosis of Axillary Lymph Node Metastasis in Patients with Breast Cancer

目的探讨乳腺X线摄影对判断乳腺癌腋窝淋巴结有无转移的价值。资料与方法搜集39例乳腺癌患者根治术后422枚腋窝淋巴结,用数字乳腺X线机对每例患者根治术后的腋窝淋巴结按大小顺序编号后行乳腺X线摄影,然后逐一行组织病理学检查,分析淋巴结的影像学表现并与其病理结果对照。结果转移淋巴结114枚,非转移淋巴结308枚。淋巴结长径≥12 mm时,两者分别为60枚、92枚;淋巴结短径≥8 mm时,两者分别为73枚、103枚;长×短径值≥130 mm2时,两者分别为66枚、52枚。两者类圆形分别为10枚、41枚;类椭圆形分别为42枚、133枚;不规则形分别为62枚、134枚。淋巴结内有脂肪密度者24枚、202枚;淋巴结有融合者分别为41枚、10枚。结论两组淋巴结在长径、短径、长×短径值、密度及有无融合方面经χ2检验差异有统计学意义,形状方面差异无统计学意义。乳腺X线摄影对判断乳腺癌腋窝淋巴有无结转移有一定价值。但在实际工作中,对临床指导意义有限。

Objective To study the value of the mammography in determining axillary lymph node metastasis.Materials and Methods The samples of 422 axillary lymph nodes were selected from 39 cases of breast cancer after radical mastectomy.The axillary lymph nodes were performed mammography examination.The imagings of lymph nodes were analyzed and compared with pathological findings.Results The lymph nodes were divided into metastatic lymph nodes group（n=14）and nonmetastatic lymph nodes group（n=308） according to pathological results.For the long diameter≥12 mm,there were 60 in metastatic group and 92 in nonmetastatic group.For the short diameter ≥8 mm,there were 73 in metastatic group and 103 in nonmetastatic group.For the long diameter× short diameter ≥130 mm2,there were 66 and 52 in two groups.For round shape of nodes,there were 10 and 41 in two groups.For oval shape of nodes,there were 42 and 133 in two groups.For irregular shape of nodes,there were 62 and 134 in two groups.For the nodes contained fat-density,there were 24 and 202 in two groups.For the lymph nodes fusion,there were 41 and 10 in two groups respectively.Conclusion There were statistic differences of long diameter,short diameter,long diameter× short diameter,density,fusion between two groups.While there was no statistic differences of shape between two groups.The mammography would be helpful in determining axillary lymph node metastasis.