超声综合检查和99Tc^m-硫胶体检测对乳腺癌前哨淋巴结的价值比较

Comparison of the value of ultrasonography and 99Tcm-thiocolloid in sentinel lymph nodes of breast cancer

目的探讨超声综合检查,包括经皮超声造影(CEUS)和常规超声检查,或99Tc^m-硫胶体前哨淋巴结检测对乳腺癌前哨淋巴结(SLN)的诊断价值比较。方法选取本院进行乳腺癌检查的患者120例为研究对象。患者均行常规超声、CEUS、99Tc^m-硫胶体前哨淋巴结检测,并以手术病理结果为标准,以ROC曲线分析常规超声、CEUS、99Tc^m-硫胶体前哨淋巴结检测对乳腺癌前哨淋巴结的诊断价值。结果120例乳腺癌患者中,经病理学诊断共检出168个淋巴结,其中转移性62个,非转移性106个。且以病理检查为标准,常规超声检查对乳腺癌前哨淋巴结转移的敏感度为69.4%,特异度为95.3%;CEUS检查的敏感度为83.9%,特异度为97.2%;99Tc^m-硫胶体检查的敏感度为88.7%,特异度为98.1%;三者联合检查的敏感度为93.5%,特异度为99.1%。另ROC曲线分析显示,常规超声、CEUS及99Tc^m-硫胶体检查及三者联合诊断的乳腺癌前哨淋巴结转移的AUC为0.823、0.905、0.934、0.963,联合诊断价值更高。结论CEUS、99Tc^m-硫胶体前哨淋巴结检测对乳腺癌前哨淋巴结的诊断价值均高于常规超声,且三者联合诊断敏感度、特异性更高。

Objective To explore the diagnostic value of percutaneous contrast-enhanced ultrasonography(CEUS)combined with conventional ultrasound or 99Tc^m-sulfur colloid sentinel lymph node detection in sentinel lymph node(SLN)of breast cancer.Methods A total of 120 patients who underwent breast cancer screening in our hospital.All patients underwent conventional ultrasonic,CEUS,99Tc^m-sulfur colloid sentinel lymph node detection,and the diagnostic value of conventional ultrasonic,CEUS,99Tc^m-sulfur colloid sentinel lymph node detection in breast cancer sentinel lymph node was analyzed by ROC curve based on the surgical pathological results.Results Among 120 cases of breast cancer,168 lymph nodes were detected by pathological diagnosis,including 62 metastatic and 106 non-metastatic.The sensitivity of conventional ultrasonography to sentinel lymph node metastasis of breast cancer was 69.4%and the specificity was 95.3%.The sensitivity of CEUS was 83.9%,and the specificity was 97.2%.The sensitivity was 88.7%and specificity was 98.1%.The sensitivity was 93.5%and specificity was 99.1%.In addition,ROC curve analysis showed that the AUC of sentinel lymph node metastasis of breast cancer diagnosed by conventional ultrasound,CEUS and 99Tc^m-sulfur gel combined with the three methods was 0.823,0.905,0.934 and 0.963,indicating a higher value of combined diagnosis.Conclusion CEUS,99Tc^m-sulfur colloid sentinel lymph node detection of breast cancer sentinel lymph node diagnostic value is higher than conventional ultrasound,and the three combined diagnosis sensitivity,specificity is higher.