超声评估乳腺癌腋窝淋巴结状态的研究进展

Ultrasound Evaluation of Axillary Lymph Nodes in Breast Cancer

乳腺癌是女性最常见的恶性肿瘤之一,腋窝淋巴结状态的评估是乳腺癌管理中的重要组成部分。超声评估腋窝淋巴结状态具有无创性及可重复性等优势,既能术前诊断腋窝可疑淋巴结又能为判断预后提供重要依据,被认为是检查腋窝淋巴结较可靠的方法。常规超声能从形态结构及血流状态评估淋巴结良恶性,弹性成像及超声造影可进一步获得淋巴结软硬度及微血管灌注信息,提高诊断的准确性。超声引导下穿刺活检的病理结果为进一步减少不必要的腋窝淋巴结清扫提供了更为可靠的依据。新辅助化疗前后以及靶标植入为精准评估腋窝淋巴结状态带来了可能。同时随着光声分子成像以及介入治疗等超声新领域在乳腺癌中的研究进展,超声越来越显示出广阔的应用前景。

Breast cancer is one of the most common malignant tumors in women. The assessment of axillary lymph node status is an important part of breast cancer management. Ultrasound evaluation of axillary lymph node status has advantages such as non-invasive and reproducible. It can not only diagnose axillary lymph nodes before operation,but also provide important evidence for prognosis,so it is considered as a reliable method to check axillary lymph nodes. The accuracy of conventional ultrasound in evaluating the benign and malignant lymph nodes is limited by morphology,structure and blood flow. Elastography and contrast-enhanced ultrasound can further obtain the lymph node hardness and microvascular perfusion information,and improve the accuracy of diagnosis. The pathological results of ultrasound-guided biopsy provide a more reliable basis for further reduction of unnecessary axillary lymph node dissection. It is possible to evaluate axillary lymph node status accurately before and after neoadjuvant chemotherapy and target implantation. At the same time,with the development of photoacoustic molecular imaging and interventional therapy in breast cancer,ultrasound has shown wider application prospect.