超声造影联合常规超声诊断乳腺癌前哨淋巴结的价值

Value of contrast-enhanced ultrasound combined with conventional ultrasound in the diagnosis of sentinel lymph node in breast cancer

目的探讨超声造影联合常规超声诊断乳腺癌前哨淋巴结的临床价值。方法选取2014年3月至2016年3月间深圳市福永人民医院及深圳市宝安区人民医院诊治的乳腺癌女性患者30例,分别对患者行常规超声和超声造影检查,观察常规超声、超声造影和超声造影联合常规超声对诊断乳腺癌前哨淋巴结准确性。结果 1联合检测准确性、敏感性和特异性明显高于常规造影组,差异有统计学意义(P<0.05),常规超声和超声造影相比、超声造影和联合检测相比,准确性、敏感性和特异性差异均无统计学意义(P>0.05);2常规超声、超声造影以及两者联合检测乳腺前哨淋巴结ROC曲线面积分别为0.68、0.76和0.90,常规超声和超声造影曲线下面积均明显小于联合检测,差异均有统计学意义(P<0.01或<0.05),而常规超声曲线下面积与超声造影比较差异无统计学意义(P>0.05)。结论超声造影联合常规超声对乳腺癌前哨淋巴结诊断价值较高,值得在临床上推广应用。

Objective To evaluate the value of contrast-enhanced ultrasound combined with conventional ultrasound in the diagnosis of sentinel lymph node in breast cancer. Methods Thirty cases of female patients with breast cancer in People＇s Hospital of Fuyong and People＇s Hospital of Baoan District of Shenzhen from Mar 2014 to Mar 2016 were selected. The patients were examined by conventional ultrasound and contrast-enhanced ultrasound respectively.The diagnostic accuracy of sentinel lymph nodes in breast cancer was observed by conventional ultrasound, contrast-enhanced ultrasound, and combination of the two. Results The accuracy, sensitivity and specificity of combined detection were significantly higher than those of conventional ultrasound group, P0.05. There was no significant difference between the conventional ultrasound and contrast-enhanced ultrasound in accuracy, sensitivity and specificity, and neither between contrast-enhanced ultrasound and combined detection（P0.05）. The area of ROC curve of the breast sentinel lymph nodes were 0.68, 0.76, 0.90 respectively, which were detected by conventional ultrasound, contrast-enhanced ultrasound and combined detection. The area under the conventional ultrasound curve was significantly smaller than the combined detection, P0.01. The area under conventional ultrasound and contrast-enhanced ultrasound curve was significantly smaller than that of the combined detection（P0.01 or P0.05）, but there was no significant difference between the area under conventional ultrasound curve and contrast-enhanced ultrasound（P0.05）. Conclusion Contrast-enhanced ultrasound combined with conventional ultrasound has a high value in the diagnosis of sentinel lymph node in breast cancer, which is worthy of clinical promotion.