彩色多普勒超声在乳腺癌患者腋窝淋巴结诊断中的应用

Application of Color Doppler Ultrasound in the Diagnosis of Axillary Lymph Nodes in Patients With Breast Cancer

目的分析彩色多普勒超声(color Doppler ultrasonography,CDUS)诊断乳腺癌患者腋窝淋巴结(axillary lymph nodes,ALN)的效能。方法选取2018年4月—2023年4月聊城市妇幼保健院收治的80例乳腺癌患者,均进行CDUS检查,以病理检查为“金标准”,分析CDUS诊断乳腺癌患者ALN的效能;并比较转移、未转移患者的超声图像特征及超声参数差异。结果80例患者中,“金标准”共检出48例腋窝淋巴结转移,CDUS共检出46例;以病理检查为“金标准”,CDUS诊断乳腺癌ALN的敏感度为93.75%(45/48)、特异度为96.88%(31/32)、准确度为95.00%(76/80)。Kappa检验显示,CDUS与“金标准”的一致性极好(Kappa值=0.897,P<0.001)。转移患者的内部回声不均匀占比为83.33%(40/48)、血流分布为混合型占比为87.50%(42/48)、阻力指数(resistance index,RI)为(0.79±0.20),高于未转移患者的31.25%(10/32)、0、(0.53±0.12);长径为(0.95±0.17)cm、短径为(0.69±0.13)cm,长于未转移患者的(0.71±0.11)cm、(0.40±0.05)cm;峰值流速(maximal velocity,Vmax)为(19.72±2.46)cm/s,快于未转移患者的(14.31±1.59)cm/s,差异有统计学意义(P<0.05)。结论CDUS能够诊断出乳腺癌患者的ALN转移,具有一定诊断价值,此文的研究结果为乳腺癌患者有无ALN转移的治疗方案制定提供了借鉴内容。

Objective To explore the efficacy of color Doppler ultrasound(CDUS)in the diagnosis of axillary lymph nodes(ALN)in patients with breast cancer.Methods A total of 80 patients with breast cancer admitted to Liaocheng Women and Children Health Hospital from April 2018 to April 2023 were examined by CDUS.The efficacy of CDUS in diagnosing ALN in breast cancer patients was analyzed with pathological examination as the"gold standard".And the differences in ultrasound image characteristics and ultrasound parameters between patients with and without metastasis were compared.Results Among the 80 patients,48 cases of axillary lymph node metastasis were detected by the"gold standard",and 46 cases were detected by CDUS.With pathological examination as the"gold standard",the sensitivity of CDUS in diagnosing ALN in breast cancer was 93.75%(45/48),the specificity was 96.88%(31/32),and the accuracy was 95.00%(76/80).The proportion of internal echo unevenness in patients with metastasis was 83.33%(40/48).The Kappa test showed excellent consistency between CDUS and the"gold standard"(Kappa value=0.897,P<0.001).The proportion of mixed blood flow distribution was 87.50%(42/48),and the resistance index(RI)was(0.79±0.20),which was higher than 31.25%(10/32),0,and(0.53±0.12)of patients without metastasis.The long diameter was(0.95±0.17)cm,the short diameter was(0.69±0.13)cm,and it was longer than(0.71±0.11)cm and(0.40±0.05)cm of patients without metastasis,The maximal velocity(Vmax)was(19.72±2.46)cm/s,which was faster than(14.31±1.59)cm/s in non metastatic patients,and the difference was statistically significant(P<0.05).Conclusion CDUS can diagnose ALN metastasis in breast cancer patients,which has certain diagnostic value.The results of this study provide reference for the development of treatment plans for breast cancer patients with or without ALN metastasis.