超声引导下细针及空芯针穿刺活检在乳腺癌腋窝分期中的应用价值

Application value of ultrasound-guided fine-needle and core-needle aspiration biopsy for axillary staging of breast cancer

目的探讨超声引导下细针穿刺活检和空芯针穿刺活检在乳腺癌腋窝分期中的应用价值。方法选取新诊断的乳腺癌患者48例,术前行超声引导下细针穿刺活检和空芯针穿刺腋窝淋巴结活检,以手术后病理结果为金标准,分析这两种穿刺活检的敏感性、特异性、阳性预测值和阴性预测值。结果在48例乳腺癌患者中,手术病理结果显示有腋窝淋巴结转移26例,无腋窝淋巴结转移22例。细针穿刺活检和空芯针穿刺活检诊断腋窝淋巴结转移的特异性及阳性预测值均为100%。细针穿刺活检、空芯针穿刺活检诊断腋窝淋巴结转移的敏感性分别为73.08%(19/26)、76.92%(20/26),阴性预测值分别为75.86%(22/29)、78.57%(22/28),两者以上指标比较,差异均无统计学意义(P>0.05)。结论超声引导下细针穿刺活检和空芯针穿刺活检在乳腺癌腋窝分期中具有重要价值。在考虑侵袭性和成本的情况下,可优先考虑超声引导下细针穿刺活检。

Objective To explore the application value of ultrasound-guided fine-needle and core-needle aspiration biopsy for axillary staging of breast cancer. Methods Forty-eight patients newly diagnosed as breast cancer were selected, and underwent ultrasound-guided fine-needle and core-needle aspiration axillary lymph node biopsy before operation. The postoperative pathologic result was taken as a golden standard, and the sensitivity, specificity, positive predictive value and negative predictive value of both approaches were analyzed. Results Of the 48 patients with breast cancer, the surgical pathology results showed that axillary lymph node metastasis were found in 26 cases and no axillary lymph node metastasis in 22 cases. Specificities and positive predictive values of fine-needle and core-needle aspiration biopsy for diagnosis of axillary lymph node metastasis were 100%. The sensitivities of fine-needle and core-eedle aspiration biopsy for diagnosis of lymph node metastasis were 73.08% （19/26） and 76.92% （20/26） respectively, and the negative predictive values of fine-needle and core-needle aspiration biopsy were 75.86% （22/29） and 78.57% （22/28） respectively. There were no significant differences in the sensitivity or negative predictive value between the two approaches （ P 〉 0.05 ）. Conclusion Either fine-needle or core-needle aspiration biopsy guided by uhrasound is significantly valuable for axillary staging of breast cancer. However, ultrasound-guided fine-needle aspiration biopsy is recommended considering the advantages of low cost and minimal invasiveness.