经皮超声造影在乳腺癌腋窝前哨淋巴结活检中的应用价值

Application of Percutaneous Contrast-Enhanced Ultrasound in Sentinel Lymph Node Biopsy of Breast Cancer

目的通过比较经皮超声造影与吲哚菁绿联合亚甲蓝法以评估经皮超声造影在乳腺癌腋窝前哨淋巴结活检中的应用价值。方法收集2019年10月至2020年4月于我院乳腺外科就诊的45例早期浸润性乳腺癌患者,分别将经皮注射超声造影与吲哚菁绿联合亚甲蓝两种方法应用于前哨淋巴结活检,并根据病理结果比较两种方法的检出率、检出前哨淋巴结个数,分析超声造影组诊断灵敏度及特异度。结果超声造影组与联合组检出率差异无统计学意义(95.6%vs.97.8%,P=0.557),平均前哨淋巴结检出枚数联合组优于超声造影组[(3.0±0.7)枚vs.(1.7±. 0.6)枚,P=0.00]。超声造影诊断转移性前哨淋巴结灵敏度93.3%,特异度96.4%,阳性预测值93.3%,阴性预测值96.4%,准确度95.3%。结论经皮超声造影有较高的前哨淋巴结检出率,且可以预判前哨淋巴结性质,在前哨淋巴结活检中具有较高应用价值。

Objective To evaluate values of percutaneous contrast-enhanced ultrasound in axillary sentinel lymph node biopsy of breast cancer by comparing percutaneous contrast-enhanced ultrasound with indocyanine green combined with methylene blue.Methods From October 2019 to April 2020,45 patients with early invasive breast cancer who were treated in our hospital were collected.Percutaneous contrast-enhanced ultrasound and indocyanine green combined with methylene blue were used to sentinel lymph node biopsy.According to pathological results,detection rate and numbers of sentinel lymph nodes detected by two methods were compared,and diagnostic sensitivity and specificity of contrast-enhanced ultrasound group were analyzed.Results There was no significant difference in detection rate between ultrasound contrast group and combined group( 95. 6% vs. 97. 8%,P =0. 557).Average number of sentinel lymph nodes detected in combined group was better than ultrasound contrast group [( 3. 0 ±0. 7) vs.( 1. 7±0. 6),P = 0. 00].Sensitivity of ultrasound contrast diagnosis of metastatic SLN was 93. 3%,specificity was 96. 4%,positive predictive value was 93. 3%,negative predictive value was 96. 4% and accuracy was 95. 3%. Conclusion Percutaneous contrast-enhanced ultrasound would have a high detection rate of sentinel lymph nodes,and could predict nature of sentinel lymph nodes,so it would have high application value in sentinel lymph node biopsy.