声触诊组织定量技术在判断乳腺癌腋窝淋巴结转移中的临床应用

Clinical application of virtual touch tissue quantification technique in axillary lymph node invasion of breast carcinoma

目的探讨声触诊组织定量(virtual touch tissue quantification,VTQ)技术在判断乳腺癌腋窝淋巴结转移中的临床应用。方法选取2019年7月—2019年12月在本院治疗的75例乳腺癌患者,术前应用VTQ技术评估这75例患者同侧腋窝可疑淋巴结共75枚为研究对象,以手术后病理结果作为金标准。将75枚腋窝淋巴结中转移性淋巴结共有44枚作为转移组,非转移性淋巴结共有31枚作为非转移组。根据横向剪切波速度(shear wave velocity,SWV)值与淋巴结实际状态描绘受试者工作特性曲线(ROC),寻找鉴别淋巴结转移性与非转移性的最佳截断值,评估VTQ技术诊断腋窝淋巴结状态的准确性。结果转移组患者转移性淋巴结的平均SWV值高于非转移组,差异有统计学意义(P<0.05)。绘制SWV值诊断乳腺癌腋窝淋巴结转移的ROC曲线,曲线下面积AUC=0.991(95%CI:93.6%~100%)。当鉴别转移性淋巴结与非转移性淋巴结的平均SWV值的截断点为1.8714 m/s时,灵敏度、特异度、阳性预测值和阴性预测值分别为90.91%、100%、100%、88.57%,约登指数达到最大值0.91。结论 VTQ技术在判断乳腺癌腋窝淋巴结转移中具有重要临床应用价值。

Objective To explore the clinical application of virtual touch tissue quantification(VTQ) in the diagnosis of axillary lymph node invasion of breast carcinoma.Methods 75 breast carcinoma patients admitted to Yijishan Hospital of Wannan Medical College from July 2019 to December 2019 were selected,VTQ technique was used to evaluate 75 suspected lymph nodes in the same axilla of these patients before operation.The postoperative pathological results were used as the gold standard. Of the 75 axillary lymph nodes, 44 cases metastaticlymph nodeswere divided into metastatic group and 31 cases non-metastaticlymph nodeswere divided into non-metastatic group. The working characteristic curve(ROC) of the subjects was described according to the transverse shear wave velocity(SWV) value and the actual state of the lymph nodes, and the best cut-off value was found to distinguish the metastatic and non-metastatic lymph nodes, and the accuracy of technique in the diagnosis of axillary lymph node status was evaluated.Results The mean SWV values of metastatic group were higher than those of non-metastatic group, with statistical significance(P<0.001). The ROC curve of SWV value in diagnosing axillary lymph node metastasis of breast cancer was drawn, and the area under ROC curve(AUC)was 0.991(95%CI:93.6%-100%). When the cut-off point of the average SWV value,which used todistinguish axillary metastatic lymph nodes and non metastatic lymph nodes, was 1.8714 m/s, the sensitivity, specificity, positive predictive value and negative predictive value were 90.91%,100%,100% and 88.57%,respectively.The Youden index reached a maximum of 0.91.Conclusions VTQ has important clinical value in the diagnosis of axillary lymph node invasion of breast carcinoma.