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乳腺癌腋窝淋巴结转移的超声诊断价值及临床病理相关性分析 被引量:32

Analysis of detecting value of ultrasound and the clinic-pathological features of axillary metastasis in breast cancer
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摘要 目的 回顾性研究超声检查对乳腺癌腋窝淋巴结转移的诊断价值;分析腋窝淋巴结转移乳腺癌的临床病理特征.方法 回顾性分析2012年6月至2013年6月收治的323例新发女性浸润性乳腺癌患者的临床资料,中位年龄54岁,全部接受腋窝淋巴结超声检查及病理检查.以组织病理学诊断为金标准分析超声检查对乳腺癌患者腋窝淋巴结转移的诊断价值,并依据2013年St.Gallen专家共识进行分子分型,利用χ^2检验探讨腋窝淋巴结转移乳腺癌的临床病理特点.结果 超声评价腋窝淋巴结转移灵敏度为35.6% (46/129),特异度为98.9% (181/183),阳性预测值为95.8% (46/48),阴性预测值为68.6% (181/264).入组患者Luminal A-like型11.2%(36/323),Luminal B-like型58.5%(189/323),人类表皮生长因子受体2过表达型13.3%(43/323),三阴型17.0%(55/323).单因素分析结果显示,腋窝淋巴结转移与月经状态、原发肿瘤T分期相关(χ^2=4.337、11.100,P=0.037、0.001),与原发肿瘤分子分型无明显相关性.结论 超声检查对诊断腋窝淋巴结状态具有一定价值,前哨淋巴结活检是腋窝淋巴结临床分期的重要补充.乳腺癌腋窝淋巴结转移与月经状态、肿瘤T分期具有相关性,与分子分型无明显相关性. Objectives To evaluate the value of ultrasound (US) in predicting axilla status and to investigate the clinic pathologic characters in the axillary node metastasis.Methods From June 2012 to June 2013,323 female primary breast cancer patients who received both axilla ultrasound and pathology examinations were reviewed retrospectively.The features of axillary nodes including diameter,longitudinaltransverse axis ratio,cortical thickness and blood flow grade were used to evaluate axillary status.US accuracy of axillary node metastasis was analyzed correlated with the final pathology results.The clinical and histological features associated with axillary node metastasis was analyzed by χ^2 test.Results The proportions of Luminal A-like,Luminal B-like,human epidermalgrowth factor receptor-2 positive and triple negative breast cancer were 11.1% (36/323),58.5% (189/323),13.3% (43/323) and 17.0% (55/ 323).The sensitivity,specificity,positive predictive value and negative predictive value of axilla US in the diagnosis of nodal metastasis were 35.6% (46/129),98.9% (181/183),95.8% (46/48) and 68.6% (181/264).Axillary lymph node metastasis had statistically significant correlation with menopausal status and clinical tumor size (χ^2 =4.337,11.100 ; P =0.037,0.001).Conclusions Standardized ultrasound is the basic way to evaluate axilla status.Sentinel lymph node biopsy should be done to acquire accurate preoperative staging of axilla when US shows no signs of metastasis.Axillary lymph node metastasis is significantly related to menopausal status and clinical tumor size,but not significantly related to subtype classification of primary breast cancer.
出处 《中华外科杂志》 CAS CSCD 北大核心 2014年第12期924-928,共5页 Chinese Journal of Surgery
基金 首都医学发展科研基金资助项目(2009-1011) 首都临床特色应用研究资助项目(Z131107002213007)
关键词 乳腺肿瘤 超声检查 前哨淋巴结活组织检查 病理学 Breast neoplasms Ultrasonography Sentinel lymph node biopsy Pathology
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参考文献15

  • 1Goldhirsch A,Winer EP,Coates AS,et al.Personalizing the treatment of women with early breast cancer:highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013[J].Ann Oncol,2013,24 (9):2206-2223.
  • 2Edge S,Byrd DR,Compton CC,et al.American Joint Committee on Cancer (AJCC) cancer staging manual.7th ed[M].Chicago:Springer,2010:352-357.
  • 3Hammond ME,Hayes DF,Dowsett M,et al.American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version)[J].Arch Pathol Lab Med,2010,134 (7):e48-e72.
  • 4Wolff AC,Hammond ME,Schwartz JN,et al.American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer[J].Arch Pathol Lab Med,2007,131 (1):18-43.
  • 5Choi Y J,Ko EY,Han BK,et al.High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer[J].Breast,2009,18 (2):119-122.
  • 6Lyman GH,Giuliano AE,Somerfield MR,et al.American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer[J].J Clin Oneol,2005,23 (30):7703-7720.
  • 7Lester SC,Bose S,Chen YY,et al.Protocol for the examination of specimens from patients with invasive carcinoma of the breast[J].Arch Pathol Lab Med,2009,133(10):1515-1538.
  • 8林盈,薛恩生,林礼务,何以敉,高上达,王艳,吴丽足,俞丽云.高频彩色多普勒超声诊断乳腺癌腋窝淋巴结转移的价值[J].中华医学超声杂志(电子版),2009,6(1):27-29. 被引量:33
  • 9蒋蓓琦,章华,庄志刚,等.腋窝超声在乳腺癌前哨淋巴结活检中应用价值[J/CD].中华临床医师杂志:电子版,2013,7(5):1975-1979.
  • 10Stachs A,G(o)de K,Hartmann S,et al.Accuracy of axillary ultrasound in preoperative nodal staging of breast cancer-size of metastases as limiting factor[J].Springerplus,2013,2:350.

二级参考文献15

  • 1Mc Guire WL, Clark GM. Prognostic factors and treatment decisions in axillary node negative breast cancer. N Engl J Med, 1992,326 : 1756-1761.
  • 2Folkman J. What is the evidence that tumors are angiogenesis dependent? J Natl Cancer Inst ,1990 ,82 :4-6.
  • 3Guidi AJ, Fiascher I, Harris JR, et al. Microvessel density and distribution in ductal carcinoma in situ of the breast. J Nail Cancer Inst, 1994,86:614-619.
  • 4Sehgal CM,Arger PH, Rowling SE, et al. Quantitative vascularity of breast masses by Doppler imaging., regional variations and diagnostic implications. J Ultrasound Med,2000,19:427-440.
  • 5Meyerowitz CB, Fleischer AC, Pickens DR, et al. Quantification of tumor vascularity and flow with amplitude color Doppler sonography in an experimental model: Preliminary results. J Ultrasound Med, 1996,15:827-833.
  • 6Peters Engl C, Med IM, Mirau M, et al. Color coded and spectral Doppler flow in breast carcinomas relationship with the tumor microvasculature. Breast Cancer Res Treatment, 1998,47:83-89.
  • 7Rizzatto G, Chersevani R. Breast ultrasound and technologies. Eur J Radiol, 1998,27 Suppl 2 :S242-S249.
  • 8Chaudhari MH, Forsberg F, Voodarla A. Breast tumor vascularity identified by contrast enhanced ultrasound and pathology : initial results. Ultrasonics ,2000,38 : 105-109.
  • 9Arora A, Joshi K, Nijhawan R, et al. Angiogenesis is an independent prognostic indicator in node-negative breast cancer. Anal Quant Cytol Histol,2002 ,24 :228-233.
  • 10Maja Podkrajsek,Maja Marolt Music,Maksimiljan Kadivec,Janez Zgajnar,Nikola Besic,Ana Pogacnik,Marko Hocevar. Role of ultrasound in the preoperative staging of patients with breast cancer[J] 2005,European Radiology(5):1044~1050

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