T_(1)期乳腺癌超声征象与腋窝淋巴结转移的相关性

Correlation of ultrasound features and axillary lymph node metastasis in patents with stage T_(1)breast cancer

目的探讨常规超声征象及剪切波弹性成像定量参数与T_(1)期乳腺癌(最大径均≤20 mm)同侧腋窝淋巴结转移的相关性。方法选取2021年11月至2023年12月在山西白求恩医院接受乳腺超声检查的T_(1)期乳腺癌患者213例,根据术后病理腋窝淋巴结有无转移,分为淋巴结转移组(57例)与淋巴结未转移组(156例)。以同侧腋窝淋巴结是否转移为因变量,将两组原发灶及同侧可疑腋窝淋巴结的常规超声征象、原发灶实时剪切波弹性成像定量参数均进行单因素分析,采用logistic回归模型分析超声征象与同侧腋窝淋巴结转移的关系。结果单因素分析显示,两组原发肿瘤高回声晕、Emax及可疑腋窝淋巴结最大皮质厚度比较,差异有统计学意义(P<0.05);logistic回归模型显示,高回声晕(OR=3.604,P=0.034)、高Emax(OR=1.013,P<0.001)及可疑腋窝淋巴结最大皮质厚度≥3.0 mm(OR=5.970,P=0.001)是T_(1)期乳腺癌患者同侧腋窝淋巴结转移的独立危险因素。结论原发肿瘤具有高回声晕、高Emax和可疑腋窝淋巴结最大皮质厚度≥3mm的T_(1)期乳腺癌更容易发生同侧腋窝淋巴结转移。

Objective To investigate the correlation between conventional ultrasound signs,quantitative parameters of real-time shear wave elastography,and ipsilateral axillary lymph node metastasis in stage T_(1)breast carcinoma patients(maximal diameter≤20 mm).Methods A total of 213 patients with stage T_(1)breast cancer who underwent breast ultrasound examination at Shanxi Bethune Hospital between November 2021 and December 2023 were selected,according to the presence or absence of axillary lymph node metastasis on postoperative pathology,they were divided into the lymph node metastasis group(57 cases)and the lymph node non-metastasis group(156 cases).By taking the pathologic diagnosis of lymph node metastasis as the dependent variable and the ultrasonographic signs as independent variables,conventional ultrasound signs of the primary tumour and ipsilateral suspicious axillary lymph nodes,quantitative parameters of real-time shear wave elastography of the primary tumour were subjected to univariate analysis in both groups of patients,then analysis of the relationship between ultrasound signs and ipsilateral axillary lymph node metastases using logistic regression modelling.Results Univariate analysis showed that the distinctions between groups of primary tumour hyperechoic halo,Emax,and maximum cortical thickness of suspicious axillary lymph nodes were statistically significant(P<0.05).Multifactorial binary logistic regression models showed that echogenic halo(OR=3.604,P=0.034),high Emax(OR=1.013,P<0.001),and the maximum cortical thickness of axillary lymph nodes≥3.0 mm(OR=5.970,P=0.001)were the independent hazard factors for stage T_(1)breast cancer.Conclusion Stage T_(1)breast cancer patients having hyperechoic halo,high Emax,and axillary suspicious lymph nodes with maximum cortical thickness≥3 mm are more likely to develop ipsilateral axillary lymph node metastasis.