臂围测量和水置换法评估乳腺癌相关淋巴水肿的一致性

Consistency between Arm Circumference and Water Drainage Volume in Measurements of Breast Cancer Related Lymphedema

目的观察臂围(AC)测量和上肢体积(ULV)测量评估乳腺癌相关淋巴水肿(BCRL)的相关性。方法2013年11月至2015年2月,连续收集女性单侧乳腺癌术后放疗患者281例。以肘关节鹰突中心水平下5cm和上10cm处臂围测量值的均值为AC;以上肢浸没水面至鹰突中心上15cm处的排水体积为ULV。对AC和ULV进行单因素和多因素线形回归,计算Kappa系数。结果放疗前后,两侧AC与In(ULV)的Pearson和Spearman相关系数均>0.959(P<0.001)。线性回归方程R2>0.90。两者对BCRL诊断一致率>90%(Kappa系数>0.492,P<0.001)。结论AC和In(ULV)线性关系显著。单独利用AC诊断和评估术后放疗BCRL可靠实用。

Objective To compare arm circumference (AC) and upper limb volume (ULV) in assessment of breast cancer related lymphedema (BCRL). Methods From November,2013 to February,2015,281 women with one-sided breast cancer accepting radiotherapy were consecutively enrolled.AC was measured as the means of circumference 10 cm above and 5 cm below the most eminent midpoint of olecranon.ULV was measured as the water displacement volume when the water surface reached at 15 cm above the midpoint of olecranon.Univariate and multivariable linear regressions were used between AC and ULV. Results All the correlated coefficients between AC and In(ULV) were above 0.959 (P < 0.001).For linear equations,the R2 > 0.90.The consistency of diagnoses of BCRL with AC and ULV were above 90%(Kappa > 0.492,P < 0.001). Conclusions AC and ULV are consistent in measurement of BCRL.AC is reliable and easier.