摘要
目的:探讨乳腺癌超声声像图表现结合免疫组织化学与腋窝淋巴结转移的相关性。方法选取48例病理确诊单发肿块的乳腺癌患者为样本,以乳腺癌超声声像图征象、术后免疫组织化学染色结果为自变量,术后腋窝淋巴结状态为因变量,采用二分类非条件 Logistic 回归进行分析研究。结果(1)48例乳腺癌超声图像的直接征象中形态不规则、呈小分叶、肿块内部回声不均匀、血流分级Ⅱ~Ⅲ级、RI≥0.7出现频率较高,出现率>50%。超声图像的间接征象中48例乳腺肿块有高回声晕、浅筋膜模糊或中断、Cooper 韧带模糊或中断、淋巴结最大皮质厚度≥3 mm、淋巴结血流表现为无或门型在肿块中的出现率较高,出现率>50%;(2)48例乳腺癌肿块内微血管密度(MVD)计数为(35.69±126.47)个/视野,腋窝淋巴结转组的 MVD 计数为(92.30±13.20)个/视野,腋窝淋巴结未转移组的 MVD 计数为(56.90±8.84)个/视野,腋窝淋巴结转组的 MVD 计数明显高于腋窝淋巴结未转移组的MVD 计数,差异有统计学意义(P <0.01)。乳腺癌肿瘤血流分级0~Ⅰ级 MVD 计数为(51.46±6.52)个/视野,Ⅱ~Ⅲ级 MVD 计数为(95.16±11.28)个/视野,Ⅱ~Ⅲ级 MVD 计数显著高于0~Ⅰ级,差异有统计学意义(P <0.05);(3)二分类非条件 Logistic 回归分析结果显示乳腺肿块的血流分级Ⅱ~Ⅲ级、腋窝淋巴结的最大皮质厚度≥3 mm 及肿块 MVD (P <0.05)是乳腺癌发生腋窝淋巴结转移的危险因素,OR 值分别为33.445、46.964、96.879。结论乳腺癌超声征象中的原发灶血流Ⅱ~Ⅲ级、腋窝淋巴结最大皮质厚度≥3 mm 及免疫组织化学染色 MVD值与乳腺癌患者发生腋窝淋巴结转移关系极为密切,对乳腺癌的临床诊疗方法选择具有重要价值。
Objective To explore the correlation between axillary lymph node metastases (ALNM)and ul-trasonographic characteristics of breast cancer combined with immunohistochemistry.Methods 48 breast cancer patients,who were diagnosed with single mass through pathological diagnosis,were selected in this study.With ultrasonographic characteristics of breast cancer and postoperative immunohistochemical stai-ning results as the independent variables,postoperative axillary lymph node status as the dependent varia-ble,the binary unconditioned Logistic regression was adopted for analysis.Results (1)Irregular shape, small lobular sign,uneven echo in the mass,blood classification Ⅱ - Ⅲ,RI ≥ 0.7 were frequently appeared in direct symptoms in ultrasound images of 48 cases of breast cancer patients, with the occurrence rate >50%.Among the indirect symptoms in ultrasound images of 48 cases of breast mass, there often occur high echo halo,fuzzy or interrupt of superficial fascia,fuzzy or interrupt of Cooper liga-ments,maximum cortical thickness of lymph nodes ≥3 mm,the blood flow of lymph node appeared none or gate type in the mass,with the occurrence rate >50%.(2)MVD counting is (35.69±126.47)/vision in 48 cases with breast mass.The MVD counting was (92.3±13.2)/vision in group with axillary lymph node metastasis,while (56.9 ± 8.84)/vision in group without axillary lymph node metastasis.The MVD counting in the former was obviously higher than that of the latter,with statistically significant difference (P <0.01).MVD counting was (51.46 ± 6.52)/vision in blood flow classification 0~I of breast mass, (95.16±11.28)/vision in classification Ⅱ-Ⅲ.MVD counting in the latter was obviously higher than that of the former,with statistically significant difference (P <0.05).(3)Dichotomous unconditioned Logistic regression analysis results showed that blood flow classification Ⅱ-Ⅲ in breast mass,maximum cortical thickness of axillary lymph node ≥3 mm and microvascular density (MVD)in the mass (P <0.05),were the risk factors of breast cancer to develop axillary lymph node metastasis,with the R value of 33.445, 46.964 and 96.879,respectively.Conclusion Blood flow at levelⅡ-Ⅲ in the primary lesion seen from ultrasono-graphic characteristics of breast cancer,maximum cortical thickness of ALN ≥3 mm,and MVD obtained from immunohistochemical staining were closely correlated with ALNM in patients with breast cancer,which had an important value for selecting diagnosis and treatment methods for breast cancer in clinical.
出处
《新疆医科大学学报》
CAS
2014年第3期292-295,共4页
Journal of Xinjiang Medical University
基金
国家自然科学基金(81260332)
关键词
乳腺癌
超声检查
免疫组织化学
腋窝淋巴结转移
breast cancer
ultrasonography
immunohistochemistry
axillary lymph node metastasis