超声造影对早期乳腺癌腋窝评估可行性的研究

Feasibility of contrast-enhanced ultrasound in the evaluation of axillary lymph nodes in patients with early stage breast cancer

目的探讨早期乳腺癌患者腋窝超声造影检查对腋窝病理结果判断的准确性。方法选取早期乳腺癌患者94例,术前均行腋窝超声造影检查,其诊断结果采用BI-RADS分级法表示,采用阳性率评估术前腋窝超声造影检查对腋窝病理情况预测价值的判定标准;同时分析不同病理类型状态下的预测价值。结果 94例患者中,Luminal A型23例(24.5%),Luminal B型44例(46.8%),HER2过表达型11例(11.7%),三阴型16例(17.0%)。腋窝淋巴结BI-RADS-US 3级38例,阳性率为15.8%(6/38);BI-RADS-US 4级55例,阳性率为54.5%(30/55),其中BI-RADS-US 4c级阳性率最高,阳性率为92.8%(13/14);BI-RADS-US 5级1例,为假阳性。结论超声造影检查是精准评估早期乳腺癌患者腋窝淋巴结状态的一种有价值的方法,可为临床选择合理的治疗方案提供参考。

Objective To explore the prediction accuracy of axillary lymph node results diagnosed by contrast-en-hanced ultrasound for axillary pathology results in patients with early stage breast cancer. Method 94 cases of patients with early stage breast cancer were enrolled, and contrast-enhanced ultrasound examinations of axillary lymph nodes were performed preoperatively for all the patients. The ultrasound findings were presented according to BI-RADS classifi-cation, and positive rates were used to evaluate the prediction value of preoperative ultrasound findings of axillary lymph nodes for pathological status of axilla; and the prediction value in different pathological statuses were analyzed. Result Of the 94 patients, there were 23 cases of Luminal A （24.5%）,44 cases of Luminal B （46.8%）, 11 cases of HER2 over-ex-pression （11.7%） and 16 cases of triple negative （17.0%）. The ultrasound findings of axillary lymph nodes in 38 patients were classified into BI-RADS-US category 3, and the positive rate was 15.8%（6/38）. The findings of 55 patients were classified into BI-RADS-US category 4, and the positive rate was 54.5% （30/55）; in this category, the positive rate of BI-RADS-US 4c patients was the highest （92.8%, 13/14）. There was one case of BI-RADS-US category 5, which was a false positive. Conclusion Contrast-enhanced ultrasound is a valuable method to accurately evaluate axillary lymph nodes in patients with early stage breast cancer, which can provide references for clinical selection of reasonable therapy.