超声对乳腺癌腋窝淋巴结的诊断价值

Ultrasonography in the preoperative evaluation of axillary lymph nodes in the patients with breast cancer

目的探讨超声诊断乳腺癌腋窝转移性淋巴结的临床应用价值。方法将164例乳腺癌患者依据腋窝淋巴结解剖位置分成腋下组、腋中组和腋上组并依次对3组淋巴结进行超声扫查,记录3组淋巴结的组别、大小、形态、内部回声、淋巴结门、皮髓质结构、内部血流等特征。结果超声扫查164例乳腺癌患者腋窝见淋巴结者120例,检出率为73.2%,超声对各组腋窝淋巴结的检出率分别为61.1%、21.3%和18.1%。3组淋巴结的形态、内部回声、淋巴门结构、皮髓质结构、血流状况在转移性与非转移性淋巴结中差异均有显著统计学意义(P<0.01),表现为类圆形或融合状形态、内部均匀低回声、淋巴门消失或偏心性、皮髓质结构不清、血流丰富的淋巴结具有恶性倾向,其诊断准确率分别为97.5%、95.8%、89.2%、85.8%及65.0%。结论超声是术前评估腋窝淋巴结状态的有效检查方法,对乳腺癌手术方式的选择及预后的估计具有重要参考价值。

Objective To evaluate the value of ultrasonography in diagnosis of axillary lymph node metastasis in breast cancer. Methods The axillary lymph nodes in 164 patients with breast cancer were performed by uhraonography. The location, size, shape, internal echo, lymph hilum, corticomedullary structure and flow pattern of lymph node were explored. Results The detection rate of axillary lymph nodes was 73.2%. The detection rates of axillary lymph nodes of group Ⅰ to group Ⅲ were 61.1% , 21.3% and 18.1% , respectively. There were significant differences in the shape, internal echoes, lymph hilum, corti- comedullary structure and flow pattern between malignant and benign axillary lymph nodes. The round or fused shape, internal hypoehcoeity, hilar disappearance, vague corticomedullary structure and abundant flow were mainly observed in metastatic lymph nodes, and the diagnostic accuracy for metastatic lymph nodes were 97.5%, 95.8% , 89.2%, 85.8% and 65.0% , respectively. Conclusion Uhrasonography is an effective method to evaluate the status of axillary lymph nodes before operation, which could provide important reference value for clinical treatment and prognosis of the patient with breast cancer.