国人乳腺癌腋窝淋巴结转移相关超声征象的Meta分析

Meta analysis of the correlation between ultrasonography and axillary lymph node metastasis of breast cancer in China

目的:对国人乳腺癌腋窝淋巴结转移的超声图像相关因素行Meta分析。方法:计算机检索PubMed、Embase、Cochrane图书馆、中国知网、万方数据库、维普网、中国生物医学文献数据库、Web of Science,检索词为“乳腺肿瘤”“淋巴转移”“前哨淋巴结”“超声”和“危险因素”的中英文文献,选取国人病例文献。结果:纳入13篇文献,其中乳腺癌腋窝淋巴结转移患者1491例(转移组),乳腺癌未转移患者1599例(对照组)。经过固定效应模型计算,乳腺癌腋窝淋巴结转移的超声相关因素有肿瘤内微钙化[OR=2.59(95%CI 1.99~3.36),P<0.01]、肿瘤原发灶最大径[OR=6.44(95%CI 4.00~10.37),P<0.01]、肿瘤内血流分级Ⅱ~Ⅲ级[OR=4.13(95%CI 2.75~6.19),P<0.01]及腋窝可疑淋巴结[OR=4.31(95%CI 3.49~5.32),P<0.01]。结论:超声显示肿瘤内微钙化、肿瘤原发灶最大径、肿瘤内血流Ⅱ~Ⅲ级、腋窝可疑淋巴结与乳腺癌腋窝淋巴结转移相关,是乳腺癌淋巴结转移的危险因素。

Objective:Meta analysis of the correlation between ultrasonography and axillary lymph node metastasis of breast cancer.Methods:The Chinese and English literatures of‘breast neoplams’,‘lymphatic metastasis’,‘sentinel lymph node’,‘ultrasonic’and‘risk factors’were searched in PubMed,Embase,Cochrane Library,CNKI,Wanfang Database,VIP,China Biomedical Literature Database,and Web of Science.Chinese medical record literatures were selected.Results:A total of 13 literatures were included in this meta-analysis,including 1491 cases of axillary lymph node metastasis of breast cancer(case group)and 1599 cases of non-metastasis of breast cancer(control group).After calculation by fixed effects model,ultrasonic related factors of axillary lymph node metastasis of breast cancer included intratumoral microcalcification[OR=2.59(95%CI 1.99~3.36),P<0.01],maximum diameter of primary tumor[OR=6.44(95%CI 4.00~10.37),P<0.01],intratumoral blood flow gradeⅡ~Ⅲ[OR=4.13(95%CI 2.75~6.19),P<0.01]and suspected axillary lymph node[OR=4.31(95%CI 3.49~5.32),P<0.01].Conclusions:Intratumoral microcalcification,maximum diameter of primary tumor,intratumoral blood flow gradeⅡ~Ⅲand suspected axillary lymph nodes are confirmed by ultrasound to be associated with axillary lymph node metastasis of breast cancer,which are risk factors.