超声弹性成像联合血清CK19、CEA水平在乳腺癌腋窝淋巴结转移中的诊断价值研究

Diagnostic value of ultrasonic elastography combined with serum CK19 and CEA levels in axillary lymphatic metastasis of breast cancer

目的研究超声弹性成像联合血清细胞角蛋白19(cytokeratin 19,CK19)、癌胚抗原(carcino-embryonic antigen,CEA)水平在乳腺癌腋窝淋巴结转移中的诊断价值。方法回顾性分析女性乳腺癌患者74例的临床资料。根据术后病理检查结果是否有腋窝淋巴结转移将其分为转移组(32例)与非转移组(42例)。比较2组超声弹性成像评分;分析超声弹性成像诊断乳腺癌腋窝淋巴结转移的价值;比较2组CK19、CEA水平;分析CK19、CEA对乳腺癌腋窝淋巴结转移的诊断价值;以病理诊断结果为金标准,分析超声弹性成像联合CK19、CEA诊断乳腺癌腋窝淋巴结转移的价值。结果转移组中超声弹性成像评分1、2分所占比例明显低于非转移组,3、4分所占比例明显高于非转移组(P<0.05)。超声弹性成像诊断乳腺癌腋窝淋巴结转移的敏感度为0.781,特异度为0.952,准确率为0.878。转移组CK19、CEA水平明显高于非转移组(P<0.05)。CK19、CEA诊断乳腺癌腋窝淋巴结转移的曲线下面积为0.922、0.916,敏感度为0.875、0.844,特异度为0.857、0.929,P<0.05。超声弹性成像联合CK19、CEA诊断乳腺癌腋窝淋巴结转移的敏感度为0.938,特异度为0.905,准确率为0.919。结论超声弹性成像联合CK19、CEA诊断乳腺癌腋窝淋巴结转移的价值高于其单独诊断的价值,临床可对其密切关注。

Objective To investigate the diagnostic value of ultrasonic elastography combined with serum cytokeratin 19(CK19)and carcinoembryonic antigen(CEA)levels in axillary lymph node metastasis(ALNM)of breast cancer.Methods The clinical data of 74 female patients with breast cancer were analyzed retrospectively.According to the postoperative pathological examination results of whether there was ALNM,the patients were divided into metastasis group(n=32)and non-metastasis group(n=42).The score of ultrasonic elastography was compared between the two groups.The value of ultrasound elastography in the diagnosis of ALNM of breast cancer was analyzed.The levels of CK19 and CEA were compared between the two groups.The diagnostic value of CK19 and CEA in ALNM of breast cancer was analyzed.Taking pathological diagnosis as the gold standard,the value of ultrasound elastography combined with CK19 and CEA in the diagnosis of ALNM of breast cancer was analyzed.Results The proportion of ultrasound elastography scores 1 and 2 in the metastasis group was significantly lower than that in the non-metastasis group,and the proportion of scores 3 and 4 was significantly higher than that in the non-metastasis group(P<0.05).The sensitivity,specificity and accuracy of ultrasound elastography in the diagnosis of ALNM of breast cancer were 0.781,0.952 and 0.878,respectively.The levels of CK19 and CEA in metastasis group were significantly higher than those in non-metastasis group(P<0.05).The area under the curve of CK19 and CEA in the diagnosis of ALNM of breast cancer was 0.922 and 0.916 respectively,the sensitivity was 0.875 and 0.844 respectively,and the specificity was 0.857 and 0.929 respectively(P<0.05).The sensitivity,specificity and accuracy of ultrasound elastography combined with CK19 and CEA in the diagnosis of ALNM of breast cancer were 0.938,0.905 and 0.919,respectively.Conclusion The value of ultrasound elastography combined with CK19 and CEA in the diagnosis of ALNM of breast cancer is higher than that of single diagnosis,which warrants attentionin clinical practice.