原发性乳腺癌阳性腋窝淋巴结超声影像诊断标准探讨
원발성유선암양성액와림파결초성영상진단표준탐토
Morphology-based criteria for ultrasonic assessment of axillary lymph node status in primary breast cancer
  • 万方数据
    中华医学杂志 중화의학잡지
    National Medical Journal of China
    2012年 10期 672-674 ,共3页

    霍苓%严昆%张晖%高文%付颖%范照青%范铁%王歆光%曹威%祁萌%李金锋%解云涛%王天峰%欧阳涛

    곽령%엄곤%장휘%고문%부영%범조청%범철%왕흠광%조위%기맹%리금봉%해운도%왕천봉%구양도

    乳腺肿瘤%前哨淋巴结%超声 乳腺腫瘤%前哨淋巴結%超聲
    유선종류%전초림파결%초성
    Breast neoplasms%Sentinel lymph node%Ultrasound
    目的 探讨原发性乳腺癌阳性腋窝淋巴结的超声影像判定标准.方法 回顾性分析北京大学肿瘤医院2005年5月至2010年6月收治的2256例T0-2N0原发性乳腺癌腋窝淋巴结超声声像图表现,依据形态与皮质厚度将腋窝淋巴结分为无异常组与异常组,异常组包含亚组(1)环周皮质厚度≥3 mm的规则靶环状淋巴结；(2)局部皮质厚度≥3 mm的偏心靶环状淋巴结和；(3)淋巴结门结构消失的低回声淋巴结.淋巴结影像异常组病例接受超声引导的异常淋巴结针吸细胞学检查；无异常组及细胞学非阳性的异常组病例接受前哨淋巴结活检.结果 全部病例中病理诊断腋窝淋巴结阳性692例(30.7％),其中穿刺细胞学诊断阳性214例(9.5％).在淋巴结影像异常组361例中,靶环状、偏心靶环状以及低回声淋巴结分别为42例(11.6％)、198例(54.8％)和121例(33.5％).应用超声影像标准鉴别阳性腋窝淋巴结的敏感度、特异度、阳性预测值和阴性预测值分别为35.8％、92.8％、68.7％和76.6％.结论 结合淋巴结形态学改变及皮质厚度的超声综合诊断标准有助于腋窝淋巴结转移的检查.
    목적 탐토원발성유선암양성액와림파결적초성영상판정표준.방법 회고성분석북경대학종류의원2005년5월지2010년6월수치적2256례T0-2N0원발성유선암액와림파결초성성상도표현,의거형태여피질후도장액와림파결분위무이상조여이상조,이상조포함아조(1)배주피질후도≥3 mm적규칙파배상림파결；(2)국부피질후도≥3 mm적편심파배상림파결화；(3)림파결문결구소실적저회성림파결.림파결영상이상조병례접수초성인도적이상림파결침흡세포학검사；무이상조급세포학비양성적이상조병례접수전초림파결활검.결과 전부병례중병리진단액와림파결양성692례(30.7％),기중천자세포학진단양성214례(9.5％).재림파결영상이상조361례중,파배상、편심파배상이급저회성림파결분별위42례(11.6％)、198례(54.8％)화121례(33.5％).응용초성영상표준감별양성액와림파결적민감도、특이도、양성예측치화음성예측치분별위35.8％、92.8％、68.7％화76.6％.결론 결합림파결형태학개변급피질후도적초성종합진단표준유조우액와림파결전이적검사.
    Objective To evaluate the morphology-based criteria for the ultrasonic assessment of axillary lymph node in primary breast cancer.Methods A total of 2256 T0-2N0 patients underwent axillary ultrasound preoperatively.Lymph nodes were classified as normal if no node was found or cortex thickness was even and ＜3 mm; abnormal,( 1 ) if cortex thickness was even but ≥3 mm or (2) focally thickened cortex ≥3 mm or (3) fatty hilum was absent.The patients in the abnormal group underwent ultrasound guided fine-needle aspiration (US-FNA).Except for positive lymph nodes,all the others underwent sentinel lymph node biopsy (SLNB).Results In this series,692 (30.7％ ) were pathologically confirmed positive LNs.Among them,214 (9.5％ ) were identified by US-FNA.And 361 were abnormal according to the above mentioned criteria.The proportions were 11.6％,54.8％ and 33.5％ in Group 1-3 respectively.The sensitivity,specificity,positive and negative predictive values of these criteria alone were 35.8％,92.8％,68.7％ and 76.6％ respectively.Conclusion The present morphology-based criteria for the ultrasonic assessment of lymph node status is both effective and practical in primary breast cancer.
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