多排螺旋CT评估腋窝淋巴结预测乳腺癌手术方式的研究

The evaluation of multi - detector row spiral CT on axillary lymph nodes for breast cancer opera-tion mode selection

目的通过采用多排螺旋CT（MDCT）评估腋窝前哨淋巴结，为乳腺癌手术方式的选择提供参考。方法随机选取行乳腺癌手术治疗的213例患者作为研究对象，入选的标准为：（1）未进行术前化疗；（2）术前进行了多排螺旋CT检查；（3）术中进行了腋窝淋巴结的活检。结果病理学检测结果显示为腋窝淋巴结转移的患者共有27例，最大淋巴结的直径平均值为10．5mm，非淋巴结转移的患者共有64例，最大淋巴结的直径平均值为6．9mm；CT结果显示淋巴结为圆形，且不包含脂肪组织显影的患者为31例，淋巴结为圆形或者椭圆形，包含脂肪组织显影的患者为60例。统计学的结果显示腋窝最大淋巴结直径大于10mm，且不包含脂肪组织显影的患者，可以认为发生腋窝淋巴结转移；而最大淋巴结直径小于8mm，且包含脂肪影像，可以被认为淋巴结转移阴性，差异有统计学意义（P〈0．01）。结论MDCT可以作为淋巴结活检的一种有效补充手段来评估腋窝淋巴结的转移情况．为乳腺痛手术方式的诜柽椐供参考．

Objective Muhi - detector row spiral CT （MDCT） was used to evaluate axillary lymph nodes for breast cancer operation mode selection. Methods 213 patients who underwent surgery of the breast during the period of January 2010 to December 2014 were selected. The inclusion criteria were as follows： （1） no preoperative chemotherapy; （2） MDCT before the surgery; （3） axillary lymph node removal during the surgery. Results The number of patients who had lymph node metastasis was 27 and their largest lymph node was 10. 5 mm in diameter. The number of non - metastasis patients was 64 and their largest lymph node was 6. 9 mm in diameter. CT results showed that the number of patients who had round lymph nodes and contained no fat concentration was 31, and the number of patients who had cuneate or round lymph nodes and contained a fat concentration was 60. Statistical results showed lymph nodes that were round, had a diameter of at least 10 mm and contained no fat concentration were considered as lymph node metastasis, while those that were round, had a diameter of less than 8 mm and contained the fat con- centration were considered as non - metastasis. Conclusion MDCT could be used as an effective assistant method for evaluating axillary lymph nodes and providing the reference for the breast cancer operation mode selection.