超声造影联合NLR在乳腺癌合并淋巴结转移中的应用分析

Application of Contrast-enhanced Ultrasound Combined with NLR in Breast Cancer with Lymph Node Metastasis

目的 分析超声造影联合中性粒细胞与淋巴细胞比值(NLR)对乳腺癌合并淋巴结转移的评估价值。方法 以2020年1月~2022年9月本院收治的99例乳腺癌患者为研究对象,对其进行超声造影检查及血常规检查,以术后病理诊断结果为金标准,根据是否合并淋巴结转移分为转移组(n=57)和无转移组(n=42)。比较转移组与无转移组的超声造影参数及外周血NLR水平,采用Pearson相关性分析超声造影参数及外周血NLR水平与淋巴结转移数目的相关性,并以受试者特征工作曲线(RDC)评价超声造影参数及外周血NLR对乳腺癌合并淋巴结转移的评估价值。结果 转移组的对比剂到达时间(AT)、对比剂达峰时间(TTP)、峰值强度(PI)与无转移组比较差异不显著(P>0.05);转移组的淋巴结实质内高灌注区和低灌注区的差异度(SI_(max)-SI_(min))及外周血N L R水平高于无转移组(P<0.05);SI_(mxa)-SI_(min)及NLR水平与淋巴结转移数量均正相关(r=0.467,0.395,P<0.05)。ROC分析显示,SI_(max)-SI_(min)、NLR单独及联合评估乳腺癌合并淋巴结转移的ROC曲线下面积(AUC)分别为0.964、0.731、0.982,临界值分别为24.96、2.37,灵敏度分别为84.21%、64.91%、85.96%,特异性分别为92.86%、69.05%、100.00%,联合评估效能优于单独评估。结论 超声造影检查及外周血NLR水平检测对于乳腺癌合并淋巴结转移均具有一定的评估价值,,二者联合评估效能更佳。

Objective To analyze the value of contrast-enhanced ultrasound combined with neutrophil lymphocyte ratio(NLR) in the evaluation of breast cancer with lymph node metastasis.Methods 99 patients with breast cancer who were treated in our hospital from January 2020 to September 2022 were selected as the study subjects,and they were examined by contrast-enhanced ultrasound and blood routine exa mination.Based on the pathological diagnosis results after surgery,they were divided into metastasis group(n=57) and non metastasis group(n=42) according to whether they had lymph node metastasis.The contrast-enhanced ultrasound parameters and peripheral blood NLR levels were compared between the metastatic group and the non metastatic group.Pearson correlation analysis was used to analyze the correlation between the contrast-enhanced ultrasound parameters and peripheral blood NLR levels and the number of lymph node metastases.The evaluation value of contrast-enhanced ultrasound parameters and peripheral blood NLR on breast cancer with lymph node metastasis was evaluated by receiver operating characteristic curve(ROC).Results There was no significant difference in the arrival time(AT),peak time(TTP) and peak intensity(PI) between the metastatic group and the non-metastatic group(P>0.05);The difference between high and low perfusion areas in lymph node parenchyma(SI_(max)-SI^(min)) and the level of NLR in peripheral blood in metastatic group were higher than those in non-metastatic group(P<0.05);The levels of Slmax-SIMin and NLR were positively correlated with the number of lymph node metastasis(r=0.467,0.395,P<0.05).The ROC results showed the area under the ROC curve(AUC) of SI_(max) SI_(min),NLR and their combined assessment of breast cancer with lymph node metastasis were 0.964,0.731 and 0.982 respectively,the critical values were 24.96and 2.37 respectively,the sensitivity was 84.21%,64.91% and 85.96% respectively,and the specificity was 92.86%,69.05% and 100.00% respectively.The combined assessment efficiency was significantly better than that of each indicator evaluated alone.Condlusion Contrast enhanced ultrasonography and peripheral blood NLR level detection have certain evaluation value for breast cancer with lymph node metastasis,and their combined evaluation is more effective.