乳腺癌超声征象联合血管内皮因子C在老年乳腺癌腋窝淋巴结转移中的诊断价值

Research of clinical value of ultrasonic manifestations of breast cancer combined with vascular endothelial factor C in older axillary lymph node metastasis of breast cancer

目的探讨乳腺癌超声征象联合肿瘤组织血管内皮生长因子(VEGF)-C在老年乳腺癌腋窝淋巴结转移中的诊断价值。方法选择老年乳腺癌患者50例,利用免疫组织化学染色检测标本中VEGF-C的表达水平,分析乳腺癌超声征象与VEGF-C表达与乳腺癌患者腋窝淋巴结状态。结果 50例老年乳腺癌患者中,腋窝淋巴结转移28例,未转移22例,乳腺癌病灶最小为0.7 cm×0.6 cm,最大为7.0 cm×6.3 cm;其中大于2cm的35例,具有较为典型的恶性肿瘤超声特征,表现为形态不规则的较低回声区,呈"蟹足样",无包膜回声,后方回声衰减,内部回声不均匀;肿瘤>2 cm患者淋巴结转移率明显高于肿瘤≤2 cm者,肿瘤边界不清楚或有毛刺者淋巴结转移率明显高于肿瘤边界清楚者(P<0.05);乳腺癌患者病灶内超声血流信号分级越低,乳腺癌病灶越小(P<0.05);乳腺癌患者病灶内超声血流信号分级越高,乳腺癌患者腋窝淋巴结转移率越高(P<0.05);50例乳腺癌患者中VEGF-C表达阳性28例,其中淋巴结转移者24例,乳腺癌淋巴结转移患者VEGF-C阳性表达率明显高于乳腺癌淋巴结未转移患者(P<0.05)。结论乳腺癌腋窝淋巴结转移主要表现为淋巴结结构的改变,当腋窝淋巴结发生实变、实质厚度不均时,可疑为转移性淋巴结,老年乳腺癌超声肿瘤内彩色血流信号丰富程度及VEGF-C阳性表达率与腋窝淋巴结发生转移密切相关。

Objective To explore the ultrasonic manifestations of breast cancer combined with tumor vascular endothelial growth factor C( VEGF-C) to assess the diagnostic value of the axillary lymph node metastasis of breast cancer for the elderly. Methods 50 old patients with breast cancer were selected. Immunohistochemical staining test was used to detect the expression of VEGF-C,clinical values of ultrasonic manifestations of breast cancer and the expression of VEGF-C for axillary lymph node status in patients with breast cancer were analyzed. Results Among 50 cases of elderly patients with breast cancer,there were 28 cases of axillary lymph node metastases,22 cases without axillary lymph node metastases. Breast cancer minimum lesions was 0. 7 cm × 0. 6 cm,the maximum was 7. 0 cm × 6. 3 cm. There were35 cases whose lesion was larger than 2 cm,and with a relatively typical sonographic features of malignancy,showed the irregular form was keyed acoustic area,a ' crab pattern',no coated echoes,rear echo attenuation,echogenicity,uneven. Lymph node metastasis rate of lesion >2 cm was significantly higher than that of the tumor ≤2 cm. Lymph node metastasis rate of the tumor boundary unclear or with burr was significantly higher than that of the tumor boundary clear( P < 0. 05). Lower grade of breast cancer lesions ultrasound blood flow signals,the smaller the breast lesions( P < 0. 05). Higher grade of breast cancer lesions ultrasound blood flow signals,higher the rate of lymph node metastasis( P < 0. 05). There were 28 patients with positive expression of VEGF-C,including 24 cases with lymph node metastasis. VEGF-C positive expression rate of lymph node metastasis was significantly higher than that of patients with without lymph node metastasis( P < 0. 05).Conclusions Axillary lymph node metastasis of breast cancer is mainly characterized by changes in the structure of lymph nodes,consolidation occurs when the axillary lymph nodes,uneven thickness of substance,suspicious for metastatic lymph nodes. Senile breast cancer tumors of ultrasonic color doppler signal richness and VEGF-C positive expression rate are closely related to the axillary lymph node metastasis.