乳腺癌常规超声及剪切波弹性成像表现与淋巴结转移关系的研究

Relationship study between the features of conventional ultrasound ＆ shear wave elasticity and axillary lymph node involvement in breast cancer

目的探讨乳腺癌原发灶常规超声征象及实时剪切波弹性成像定量参数弹性模量值与腋窝淋巴结转移之间的关系。方法169例乳腺癌患者根据术后病理分为淋巴结转移组（115例）与未转移组（54例），单因素分析两组乳腺癌原发灶的术前常规超声征象及剪切波弹性模量值，筛选出有统计学意义的因素，然后用多因素Logistic回归分析其与淋巴结转移的关系。结果单因素分析结果显示，淋巴结转移组的乳腺癌原发灶微钙化与高回声晕的检出率分别为81．7%（94／115）与71．3％（82／115），均明显高于未转移组的61．1％（33／54）与50．0％（27／54），淋巴结转移组的乳腺癌原发灶弹性模量最大值（Emax）高达（182．2±74．0）kPa，明显大于未转移组的（153．3±76．9）kPa，差异均有统计学意义（P〈0．05）；多因素分析结果显示，乳腺癌原发灶的微钙化（OR=2．498，P=0．022）、高回声晕（OR=2．482，P=0．013）及Emax（OR=1．007，P=0．007）均为淋巴结转移的独立危险因素。结论具有微钙化、高回声晕征象及高Emax的乳腺癌原发灶更容易发生腋窝淋巴结转移。

Objective To investigate the correlation between the features of conventional ultrasound shear wave elasticity and axillary lymph node involvement in breast cancer. Methods A total of 169 breast cancers patients were divided into lymph node metastasis group（ n = 115） and non metastasis group （n = 54） according to the postoperative pathological results. Preoperative conventional ultrasonographic features and preoperative shear wave elastography quantitative parameters （E values） of the two groups breast lessons were analyzed by single factor analysis to screen out statistically significant factors, then Logistic regression analysis was performed to analyze the relationship between above factors and lymph node involvement. Results Single factor analysis showed the microcalcification and hyperechoic halo detection rates of lymph node metastasis group [81.7%（94/115） and 71.3%（82/115）,respectively] were higher than those in non metastasis group [61.1 % （33/54） and 50.0% （27/54）, respectively]. The elastography maximum value（Emax） of lymph node involvement group was （182.2 ± 74.0）kPa, which was larger than that in non metastasis group＇ s （153.3 ± 76.9） kPa （ P 〈0.05）. Multivariate Logistic regression analysis showed the microcalcification（OR = 2. 498, P = 0. 022）, the hyperechoic halo（OR = 2. 482, P = 0. 013） and the Emax value（OR = 1. 007, P = 0. 007） were risk factors of axillary lymph node metastasis in breast cancer. Conclusions Breast cancer with microcalcification, hyperechoic signs and high Emax value is more likely to develop axillary lymph node metastasis.