专项超声对早期乳腺癌腋下淋巴结的评估价值

Diagnosis performance of post biopsy ultrasound for axiUary lymph node of clinically node negative breast cancer

目的探讨术前专项超声对于临床体检腋窝淋巴结阴性乳腺癌腋下转移性淋巴结的诊断价值。方法对96例乳腺原发病灶粗针穿刺活检确诊为浸润性癌的病例，术前指定具有20年以上乳腺诊断经验的超声医师对同侧腋窝进行有针对性的扫查。超声诊断结果与病理结果对照，分析专项超声诊断与淋巴结病理结果的符合率，并比较常规超声与专项超声的诊断效能。结果96例病例中，病理证实前哨淋巴结有转移17例。术前专项超声诊断前哨淋巴结转移的灵敏性47．1％，特异性88．6％，阳性预测值47．1％，阴性预测值88．6％，准确度81．3％。常规超声诊断腋下淋巴结的灵敏性23．5％，特异性100％，阳性预测值100％，阴性预测值85．9％，准确度86．5％。结论专项超声对于临床体检腋窝阴性的早期浸润性乳腺癌腋下转移性淋巴结有一定的诊断价值；相比常规超声，专项超声灵敏度增高，特异度降下低。

Objective To investigate the role of additional post-core biopsy ultrasound in clinically node negative breast cancer. Methods Axillary ultrasound was performed before and after breast cancer was diagnosed on core biopsy samples. Post-core biopsy ultrasound were performed by radiologists of this department of ultrasound at random. Post-diagnosis ultrasounds were performed by a radiologist with over 20 years of experience for the diagnosis of breast cancer with axillary disease. Results were compared to the final axillary pathological result. Results Of the 96 patients,17 were pathology lymph node positive. Post biopsy ultrasound identified 8 of the 17 positive nodes, with a sensitivity 47.1 %, specificity 88.6 %, positive predictive value of 47.1%, negative predictive value of 88.6% ,accuracy of 81.3%. While the diagnosis index of pre-biopsy ultrasound were 47.1% ,88.6% ,47.1% ,88.6% ,81.3% ,respectively. Conclusions Post-biopsy ultrasounds had an increased sensitivity for identifying positive axillary nodes,at the same times, specificity decreased.