CAJ | 학술논문

目的：利用高频超声探讨乳腺癌患者腋中组转移性淋巴结的声像学特征。方法2008年1月至2013年10月在中山大学肿瘤防治中心行超声检查，并发现腋中组存在淋巴结病例共89例，均为女性乳腺癌患者，其中66例为乳腺癌首诊患者，23例为乳腺癌术后复查患者。观察腋中组淋巴结的数量、最大径、纵横比及是否存在淋巴门、血流情况。统计学分析出有意义的参数，并计算其敏感度、特异度、阳性预测值及阴性预测值。结果超声检查发现腋中组淋巴结数量≥3个，诊断淋巴结良恶性的敏感度为56.8%，特异度为89.7%，准确性为71.9%，阳性预测值和阴性预测值分别为87.9%和61.4%；若腋中组有一个淋巴结最大径≥10 mm，则诊断淋巴结良恶性的敏感度为58.0%，特异度为79.5%，准确性为67.4%，阳性预测值和阴性预测值分别为78.4%和59.6%；如果同时存在两个声像学特征，则可明显提高诊断的敏感度（87.8%）和准确性（78.6%），特异度为60.0%，阳性预测值为72.3%，阴性预测值为80.0%。结论腋中组淋巴结的数量和大小是判断淋巴结良恶性有意义的声像图指征。
목적：이용고빈초성탐토유선암환자액중조전이성림파결적성상학특정。방법2008년1월지2013년10월재중산대학종류방치중심행초성검사，병발현액중조존재림파결병례공89례，균위녀성유선암환자，기중66례위유선암수진환자，23례위유선암술후복사환자。관찰액중조림파결적수량、최대경、종횡비급시부존재림파문、혈류정황。통계학분석출유의의적삼수，병계산기민감도、특이도、양성예측치급음성예측치。결과초성검사발현액중조림파결수량≥3개，진단림파결량악성적민감도위56.8%，특이도위89.7%，준학성위71.9%，양성예측치화음성예측치분별위87.9%화61.4%；약액중조유일개림파결최대경≥10 mm，칙진단림파결량악성적민감도위58.0%，특이도위79.5%，준학성위67.4%，양성예측치화음성예측치분별위78.4%화59.6%；여과동시존재량개성상학특정，칙가명현제고진단적민감도（87.8%）화준학성（78.6%），특이도위60.0%，양성예측치위72.3%，음성예측치위80.0%。결론액중조림파결적수량화대소시판단림파결량악성유의의적성상도지정。
Objective To evaluate the feature of level Ⅱaxillary lymph nodes from breast cancer detected by ultrasound. Methods Eighty-nine cases of breast cancers with level Ⅱaxillary lymph nodes diagnosed in Sun Yat-sen University Cancer Center from January 2008 to October 2013 were retrospectively studied, including 66 cases of breast cancer patients pre-operatively, 23 cases of breast cancer post-operatively, all cases were female. The number, size, long/short ratio, presence of a hilum, and Doppler features of the lymph nodes were observed. The accuracy sensitivity, speciifcity, positive predictive value (PPV), and negative predictive value (NPV) of each signiifcant parameter were analyzed. Results Ultrasound examination revealed more than axillary lymph nodes, the accuracy sensitivity, specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 71.9%, 56.8%, 89.7%, 87.9%and 61.4%respectively. The maximum diameter of levelⅡaxillary lymph node was more than or equal to 10 mm, the accuracy sensitivity, specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 67.4%, 58.0%, 79.5%, 78.4%and 59.6%respectively. If there were two ultrasonographic characteristics simultaneously, the diagnostic sensitivity (87.8%) and accuracy (78.6%) could be significantly improved, the specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 60.0%, 72.3%and 80.0%. Conclusion The number and size of lymph nodes in level Ⅱaxillary area are valuable sonographic characteristics for the diagnosis of benign and malignant lymph nodes.