彩色多普勒超声对乳腺癌患者腋窝淋巴结转移的评估价值

The value of color Doppler ultrasound in evaluating axillary lymph node metastasis in breast cancer patients

目的:探讨观察彩色多普勒超声评估乳腺癌患者腋窝淋巴结转移的价值。方法:选取2020年1月—12月在灌云县人民医院接受治疗的77例乳腺癌患者为研究对象,所有患者均应用彩色多普勒超声进行了术前腋窝淋巴检查,以术后病理检查结果作为金标准,分析彩色多普勒超声评估乳腺癌患者腋窝淋巴结转移的价值。结果:术后病理检查结果显示,腋窝淋巴结转移患者64例,未转移患者13例。彩色多普勒超声诊断乳腺癌腋窝淋巴结转移的灵敏度、特异度和准确率分别为95.31%、69.23%和90.91%。腋窝淋巴结转移患者周边型血流信号的构成比高于未转移患者,门形血流信号的构成比低于未转移患者,差异均有统计学意义(P均<0.05),腋窝淋巴结转移患者分散型和混合型血流信号的构成比与未转移患者比较,差异无统计学意义(P均>0.05);腋窝淋巴结转移患者的Ⅲ级血流信号的构成比高于未转移患者,差异具有统计学意义(P<0.05)。腋窝淋巴结转移患者的淋巴结长短径比>2、钙化灶、边界模糊、皮质向心性增厚以及毛刺征的检出率均高于未转移患者,差异均有统计学意义(P均<0.05)。结论:彩色多普勒超声评估乳腺癌患者腋窝淋巴结转移的应用价值较好,值得临床应用。

Objective To analyze the value of color Doppler ultrasound in evaluating axillary lymph node metastasis in patients with breast cancer.Methods 77 patients with breast cancer who were treated in Guanyun People's Hospital from January 2020 to December 2022 were selected as the study subjects.All patients were examined for axillary lymph nodes before operation by double blind method.The value of color Doppler ultrasound in evaluating axillary lymph node metastasis in breast cancer patients was analyzed based on the results of postoperative pathological examination.Results The postoperative pathological examination results showed that 64 patients had axillary lymph node metastasis,while 13 patients did not.The sensitivity,specificity and accuracy of color Doppler ultrasound in the diagnosis of axillary lymph node metastasis of breast cancer were 95.31%,69.23%and 90.91%,respectively.The proportion of peripheral blood flow distribution in patients with axillary lymph node metastasis was higher than that in patients without metastasis,and the proportion of portal blood flow distribution was lower than that in patients without metastasis,with statistical significance(P<0.05).There was no significant difference in the proportion of dispersed and mixed blood flow distribution between patients with axillary lymph node metastasis and those without metastasis(P>0.05).The proportion of gradeⅢblood flow signals in patients with axillary lymph node metastasis was higher than that in patients without metastasis,and the difference was statistically significant(P<0.05).Patients with axillary lymph node metastasis had a lymph node length to diameter ratio of over 2,calcification within the lymph nodes,blurred lymph node boundaries,cortical centripetal thickening,and a higher detection rate of hair pricking signs compared to non metastatic patients,with statistically significant differences(P<0.05).Conclusions Color Doppler ultrasound in the assessment of axillary lymph node metastasis in breast cancer patients has good application value,which is worthy of clinical application.