术前能量多普勒超声检测血流信号联合CD34检测微血管密度诊断乳腺癌腋窝淋巴结转移的临床意义

Clinical significance of preoperative detection of blood flow signals and micro-vessel density by power Doppler imaging and CD34 for diagnosis of breast carcinoma patients with axillary lymph node metastasis

目的探讨术前联合能量多普勒超声(power Doppler imaging,PDI)检测血流信号及CD34检测微血管密度对乳腺癌腋窝淋巴结转移诊断的临床意义。方法以30名乳腺癌患者为研究对象,用PDI检测乳腺癌肿块内血流信号,用免疫组化法检测30例乳腺癌组织内微血管密度(microvessel density,MVD),研究乳腺癌肿瘤内血流信号及微血管密度与腋窝淋巴结转移的关系。结果研究结果显示,30名患者中有腋窝淋巴结转移患者即LN+组13例,无腋窝淋巴结转移即LN-组17例。LN+组肿块内血流信号较LN-组明显丰富(P<0.05);LN+组CD34标记的血管计数较LN-组明显增高(P<0.01)。结论术前对乳腺癌患者行PDI与MVD的联合检测,能很好评估乳腺癌血管生成,且可预测腋窝淋巴结转移的风险,对临床治疗方案的选择具有重要的参考意义。

Objective To explore the clinical significance of blood flow signal which detected by power Doppler ultrasound（power Doppler imaging,PDI） and micro-vessel density which detected by CD34 for the clinical diagnosis of breast cancer with axillary lymph node metastasis.Methods Selected 30 patients with breast carcinoma as object for this study,used PDI to detect the blood flow signal in tumor lumps,and use immunohistochemistry method to determine the microvascular density（micro-vessel density,MVD）,then research the correlation of blood flow signal and micro-vessel density in tumor lumps between axillary lymph node metastasis.Results The results of this study showed that,the number of LN ＋ patients and LN-patients was 17 and 13 respectively,among the 30 patients.The blood flow signals of LN ＋ group was much richer than the LN-group（P〈0.05）,and the vessel count of LN ＋ group which determine by CD34 detection was higher than LN-group significantly（P〈0.01）.Conclusions Undertaking the combined detection with PDI and MVD for breast cancer patients in preoperative could receive a good assessment of angiogenesis in tumor lumps,and could predict the risk of axillary lymph node metastasis well,has an important clinical significance for the choice of the treatment programs.