超声造影联合术中快速免疫组化检测在乳腺癌前哨淋巴结活检中的应用研究

Application of contrast-enhanced ultrasound combined with intraoperative rapid immunohistochemical detection in sentinel lymph node biopsy of breast cancer

目的探讨乳腺癌前哨淋巴结(SLN)采用超声造影(CEUS)联合术中快速免疫组化检测的效果。方法回顾性分析2020年1月至2022年6月萍乡市妇幼保健院接受手术治疗的80例乳腺癌患者临床资料。所有患者术前均接受CEUS检查,并行美蓝染色及术中快速免疫组化检测,以术后病理检查为金标准,分析CEUS联合术中快速免疫组化检测在乳腺癌SLN转移中的应用价值。结果80例乳腺癌患者均成功实施CEUS,超声检测的SLN成功采用美蓝染色,共检出SLN110枚;110枚SLN经术后病理检查转移47枚,未转移63枚;CEUS联合术中快速免疫组化检测乳腺癌SLN转移的灵敏度、特异度、准确度分别为95.74%、100.00%、98.18%,均高于单一CEUS、术中快速免疫组化检测,差异有统计学意义(P<0.017)。结论CEUS联合术中快速免疫组化检测乳腺癌SLN转移的评估中有较高的准确性。

Objective To investigate the effect of contrast-enhanced ultrasound(CEUS)combined with intraoperative rapid immunohistochemical detection in breast cancer sentinel lymph node(SLN).Methods Clinical data of 80 patients with breast cancer who received surgical treatment in Pingxiang Maternal and Child Health Hospital from January 2020 to June 2022 were retrospectively analyzed.All patients received preoperative CEUS and underwent merocyanine staining and in-traoperative rapid immunohistochemistry detection,and postoperative pathological examination was used as the gold stan-dard to analyze the application value of CEUS combined with intraoperative rapid immunohistochemistry detection in SLN metastasis of breast cancer.Results All 80 breast cancer patients were successfully implemented ultrasonography,ultra-sound detected SLN was successfully stained with methylene blue,a total of 110 SLN were detected.110 SLN were metasta-sized 47 and not metastasized 63 after postoperative pathological examination.The sensitivity,specificity and accuracy of rapid immunohistochemical detection of SLN metastasis in combination with CEUS were 95.74%,100.00%and 98.18%,respectively,which were higher than single CEUS and intraoperative rapid immunohistochemical detection,and the differ-ences were statistically significant(P<0.017).Conclusion Ultrasonography combined with intraoperative rapid immuno histochemistry detection of SLN metastasis in breast cancer has high accuracy in the evaluation.