超声联合细针穿刺诊断乳腺癌腋窝淋巴结转移假阴性的多因素分析

Multiple factors analysis of ultrasonography combined with fine-needle aspiration for diagnosing false negative in axillary lymph node metastasis of breast cancer

目的分析影响腋窝超声(AUS)联合超声引导下淋巴结细针穿刺细胞学检查(US-FNAC)诊断乳腺癌腋窝淋巴结转移(ALNM)假阴性的临床、病理及超声影像学因素。方法回顾性分析2018年1月至2019年3月术前AUS阴性或因术前AUS有可疑淋巴结而行US-FNAC为阴性的338例早期乳腺癌患者,以术后淋巴结病理结果为金标准,计算AUS联合US-FNAC诊断乳腺癌ALNM的假阴性率,研究临床、病理及超声影像学因素与假阴性结果的相关性。结果AUS联合US-FNAC诊断乳腺癌ALNM的假阴性率为26.6%(90/338)。多因素分析显示,肿瘤大小、淋巴管癌栓和淋巴结超声分类是预测假阴性结果的独立影响因素(P<0.05)。结论临床病理因素和AUS特征可用于预测AUS联合US-FNAC诊断早期浸润性乳腺癌ALNM的假阴性结果。

Objective To assess the clinical,pathological and ultrasound imageological factors of axillary ultrasonography(AUS)combined with ultrasound-guided fine-needle aspiration cytology(US-FNAC)for diagnosing the false negative in axillary lymph node metastasis(ALNM)of breast cancer.Methods Three-hundred thirty-eight patients with early-stage breast cancers who were preoperative AUS negative or conducted US-FNAC due to suspicious lymph node by AUS from January 2018 to March 2019 were retrospectively analyzed.The postoperative pathological results of lymph node served as the golden standard.The false-negative rate of for AUS combined with US-FNAC in diagnosing ALNM of breast cancer was calculated.Then the correlation between the clinical,pathological and ultrasound imagiological factors with the false negative results was investigated.Results The false-negative rate of AUS combined with US-FNAC in diagnosing ALNM of breast cancer was 26.6%(90/338).The multivariate analysis showed that the tumor size,lymphatic vessel embolus and lymph node ultrasound types were the independent influencing factors for predicting the false negative results(P<0.05).Conclusion The clinicopathological factors and AUS characteristics could be used to predict the false negative results of AUS combined with US-FNAC in diagnosing ALNM of early invasive breast cancer.