二维超声与超声弹性成像诊断乳腺癌腋窝淋巴结转移的价值

The Value of Two-Dimensional Ultrasound and Ultrasonic Elastography in the Diagnosis of Axillary Lymph Node Metastasis of Breast Cancer

目的探讨乳腺癌患者腋窝淋巴结转移应用二维超声(two dimensional ultrasound,2DUS)联合超声弹性成像检查的实际价值。方法将80例乳腺癌患者(腋窝淋巴结共83枚)作为本次研究对象,对所有患者均予以二维超声(2DUS)与超声弹性成像检查,所有患者均于2019年3月—2022年3月被龙岩市第二医院收治,“金标准”参考病理检查结果,对超声弹性成像、2DUS以及超声弹性成像联合2DUS的检查结果进行记录与分析。结果转移性淋巴结患者检测例数33(97.06%)、28(82.35%)、31(91.18%)、29(85.29%)均高于未转移患者19(8.78%)、18(36.73%)、11(22.45%)、10(20.41%),差异有统计学意义(P<0.05);转移性淋巴结患者超声弹性成像评分1(2.63%)、20(52.63%)、11(28.95%)相较于未转移者超声弹性成像评分25(55.56%)、11(24.44%)、1(2.22%),差异有统计学意义(P<0.05);2DUS联合超声弹性成像诊断灵敏度与准确度(95.83%、92.77%)均高于单一2DUS(64.58%、75.90%)、超声弹性成像(70.83%、78.31%),差异有统计学意义(P<0.05),三组特异度对比差异无统计学意义(P>0.05)。结论乳腺癌腋窝淋巴结转移使用2DUS联合超声弹性成像诊断效果显著,准确性与灵敏度较高,能够准确判断与评估病情,以便于及时调整治疗方案。

Objective To discuss the clinical value of twodimensional ultrasonography(2DUS)and ultrasonic elastography on the differential diagnosis of breast carcinoma with axillary lymph node metastasis.Methods80 breast carcinoma patients(83 axillary lymph nodes)treated from March 2019 to March 2022 in the Second Hospital of Longyan were selected as research subjects.2DUS and ultrasonic elastography were performed.The pathological examination results were seen as gold standard.The diagnosis results based on ultrasonic elastography,2DUS or ultrasonic elastography plus2DUS were recorded.Results The detection cases of 2DUS examination signs in lymph node metastasis patients were33(97.06%),28(82.35%),31(91.18%)and 29(85.29%),which were significantly higher than non-metastasis patients[19(8.78%),18(36.73%),11(22.45%),10(20.41%)].The difference was statistically significant(P<0.05).The ultrasound elastic imaging scores of patients with metastatic lymph nodes were 1(2.63%),20(52.63%)and 11(28.95%),which were significantly lower than non-metastasis patients[25(55.56%),11(24.44%),1(2.22%)].The difference was statistically significant(P<0.05).The diagnosis sensitivity and accuracy based on 2DUS and ultrasonic elastography(95.83%,92.77%)were higher than those based on 2DUS(64.58%,75.90%)or ultrasonic elastography(70.83%,78.31%),and the difference was statistically significant(P<0.05).There were no significant differences about the diagnosis specificity based on ultrasonic elastography,2DUS or ultrasonic elastography plus 2DUS(P>0.05).Conclusion 2DUS and ultrasonic elastography can effectively increase the diagnosis accuracy and sensitivity,evaluate the illness states and make for the selection of proper treatment schemes.