经皮内超声造影在乳腺癌前哨淋巴结转移诊断中的应用价值

Application value of percutaneous contrast-enhanced ultrasound in the diagnosis of sentinel lymph node metastasis in breast cancer

目的探讨经皮内超声造影(CEUS)诊断乳腺癌前哨淋巴结转移的应用价值。方法对200例乳腺癌患者进行CEUS检查,与病理结果进行比较,分析诊断乳腺癌前哨淋巴结转移的价值。结果200例乳腺癌患者中,有192例患者CEUS检出244枚前哨淋巴结,其中转移性淋巴结75枚,非转移性淋巴结169枚;增强模式A型130枚,占53.28%,B型98枚,占40.16%,C型16枚,占6.56%;CEUS诊断转移性前哨淋巴结的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为96.00%、75.15%、81.56%、63.16%和97.69%。转移性前哨淋巴结纵径、横径均明显长于非转移性前哨淋巴结,差异均有统计学意义(P﹤0.01);纵径、横径诊断转移前哨淋巴结的受试者工作特征(ROC)曲线的曲线下面积分别为0.871和0.746,联合诊断的灵敏度和特异度分别为82.50%和76.00%。结论CEUS诊断乳腺癌前哨淋巴结转移有较高的价值,值得临床使用。

Objective To explore the value of percutaneous contrast-enhanced ultrasound(CEUS)in the diagnosis of sentinel lymph node metastasis in breast cancer.Method CEUS was performed on 200 breast cancer patients and compared with the pathological results to analyze this method’s diagnostic value of breast cancer sentinel lymph node metastasis detection.Result Among 200 breast cancer patients,a total of 244 sentinel lymph nodes were detected by CEUS in 192 patients,of which 75 were metastatic lymph nodes and 169 were non-metastatic lymph nodes.Among them,the pattern of enhancement type A was 130,accounting for 53.28%,type B was 98,accounting for 40.16%,and type C was 16,accounting for 6.56%;the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of CEUS in the diagnosis of metastatic sentinel lymph nodes were 96.00%,75.15%,81.56%,63.16%,and 97.69%,respectively.The longitudinal and transverse diameters of metastatic sentinel lymph nodes were significantly longer than those of non-metastatic sentinel lymph nodes,and the differences were statistically significant(P<0.01).The area under the curve of the receiver operating characteristic(ROC)curve for the diagnosis of metastatic sentinel lymph nodes in longitudinal and transverse diameters were 0.871 and 0.746,respectively,and the sensitivity and specificity of combined diagnosis were 82.50% and 76.00%,respectively.Conclusion CEUS,which is worthy of clinical use,has high and promising value in diagnosing sentinel lymph node metastasis of breast cancer.