超声影像在乳腺癌腋窝淋巴结转移诊断中的临床应用价值

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Abstract Objective To evaluate the clinical value of ultrasonography in the diagnosis of axillary lymph node metastasis in breast cancer. Methods Clinical data of 682 primary invasive breast cancer patients who underwent treatment in Breast Center, Shunyi Women′s and Children′s Hospital of Beijing Children′s Hospital from January 2008 to July 2017 were studied retrospectively. Patients were divided into normal group (n = 419) and abnormal group (n = 263) depending on the morphology and cortical thickness of axillary lymph nodes through ultrasonography. The patients in the abnormal group underwent ultrasound guided fine needle aspiration (FNA). Except for patients who were diagnosed with positive axillary lymph nodes, the others underwent sentinel lymph node biopsy (SLNB). Two hundred and fifteen of the 263 cases which had abnormal lymph node diagnosis were confirmed positive by histopathology, and 99 of 419 cases which had normal lymph node diagnosis were confirmed positive by histopathology. Histopathological diagnosis was set as gold standard, the value of ultrasound classification for axillary lymph nodes was evaluated. Kappa analysis was used to evaluate the consistency of ultrasonography and histopathology. Pearson χ2 test was used to analyze the related factors of axillary lymph node metastasis. Results The sensitivity, specificity, positive and negative predictive value of ultrasonography in the diagnosis of axillary lymph node metastasis in breast cancer was 68.5%, 87.0%, 81.7%, 76.4% respectively. The ultrasonography and histopathology was in good coincidence, and the value of Kappa was 0.561. The axillary lymph node metastasis in breast cancer was related to family history of the patients (P < 0.05), but not significantly related to age, menopausal status or subtype classification (P > 0.05). Conclusion Ultrasonography has a higher clinical practical diagnostic value for axillary lymph node metastasis in breast cancer. The axillary lymph node metastasis is related to family history, but not significantly related to age, menopausal status or subtype classification.

Key words： Breast cancer Axillary lymph node metastasis Ultrasonography Diagnostic value

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WANG Jing LI Yi. Clinical application value of ultrasonography in the diagnosis of axillary lymph node metastasis in breast cancer[J]. 中国医药导报, 2018, 15(27): 70-73.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I27/70

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