中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
4期
259-262
,共4页
殷正昕%沈坤炜%李亚芬%何建蓉
慇正昕%瀋坤煒%李亞芬%何建蓉
은정흔%침곤위%리아분%하건용
乳腺肿瘤%淋巴转移%磁共振成像%超声检查
乳腺腫瘤%淋巴轉移%磁共振成像%超聲檢查
유선종류%림파전이%자공진성상%초성검사
Breast neoplasms%Lymphatic metastasis%Magnetic resonance imaging%Ultrasonography
目的 比较术前乳腺B超和乳腺MRI检查评估乳腺癌患者腋窝淋巴结状态的准确性.方法 回顾性分析2010年8月至2011年2月于上海瑞金医院乳腺疾病诊治中心进行乳腺B超、MRI检查以及根治性手术的293例乳腺癌病例.结果 293例乳腺癌患者中3例为双侧乳腺癌,共296例腋窝.总体人群中,B超敏感性达60.0％,特异性达90.6％,阳性预测值80.2％,阴性预测值78.0％；MRI敏感性达50.5％,特异性达90.8％,阳性预测值77.9％,阴性预测值74.0％；两项检查联用敏感性70.6％,特异性97.2％.两项检查的四项指标之间差异均无统计学意义(均P＞0.05),在亚组分析中两种检查的准确性及预测价值差异亦无统计学意义(P＞0.05).B超联合MRI检查的敏感性为70.6％,特异性为97.2％.结论 术前B超及MRI对乳腺癌患者腋窝淋巴结状态评估的准确性及预测价值相当.联合使用乳腺B超及MRI检查特异性更高,两种检查均提示腋窝淋巴结转移的患者可考虑免去前哨淋巴结活检.
目的 比較術前乳腺B超和乳腺MRI檢查評估乳腺癌患者腋窩淋巴結狀態的準確性.方法 迴顧性分析2010年8月至2011年2月于上海瑞金醫院乳腺疾病診治中心進行乳腺B超、MRI檢查以及根治性手術的293例乳腺癌病例.結果 293例乳腺癌患者中3例為雙側乳腺癌,共296例腋窩.總體人群中,B超敏感性達60.0％,特異性達90.6％,暘性預測值80.2％,陰性預測值78.0％；MRI敏感性達50.5％,特異性達90.8％,暘性預測值77.9％,陰性預測值74.0％；兩項檢查聯用敏感性70.6％,特異性97.2％.兩項檢查的四項指標之間差異均無統計學意義(均P＞0.05),在亞組分析中兩種檢查的準確性及預測價值差異亦無統計學意義(P＞0.05).B超聯閤MRI檢查的敏感性為70.6％,特異性為97.2％.結論 術前B超及MRI對乳腺癌患者腋窩淋巴結狀態評估的準確性及預測價值相噹.聯閤使用乳腺B超及MRI檢查特異性更高,兩種檢查均提示腋窩淋巴結轉移的患者可攷慮免去前哨淋巴結活檢.
목적 비교술전유선B초화유선MRI검사평고유선암환자액와림파결상태적준학성.방법 회고성분석2010년8월지2011년2월우상해서금의원유선질병진치중심진행유선B초、MRI검사이급근치성수술적293례유선암병례.결과 293례유선암환자중3례위쌍측유선암,공296례액와.총체인군중,B초민감성체60.0％,특이성체90.6％,양성예측치80.2％,음성예측치78.0％；MRI민감성체50.5％,특이성체90.8％,양성예측치77.9％,음성예측치74.0％；량항검사련용민감성70.6％,특이성97.2％.량항검사적사항지표지간차이균무통계학의의(균P＞0.05),재아조분석중량충검사적준학성급예측개치차이역무통계학의의(P＞0.05).B초연합MRI검사적민감성위70.6％,특이성위97.2％.결론 술전B초급MRI대유선암환자액와림파결상태평고적준학성급예측개치상당.연합사용유선B초급MRI검사특이성경고,량충검사균제시액와림파결전이적환자가고필면거전초림파결활검.
Objective To evaluate the accuracy of ultrasonography and magnetic resonance imaging detection on preoperatively predicting axillary lymph node in breast cancer patients.Methods From August 2010 to February 2011,the clinical data of 293 breast cancer patients underwent preoperative breast ultrasound exam and MRI detection in Ruijin Hospital were analyzed retrospectively.Results In 293 breast cancer patients,3 suffered from bilateral breast cancer.The sensitivity,specificity,negative predictive value and positive predictive value of ultrasound were 60.0％,90.6％,78.0％ and 80.2％,respectively.The sensitivity,specificity,negative predictive value and positive predictive value of MRI test were 50.5％,90.8％,74.0％ and 77.9％,respectively.There was no significant difference between ultrasound and MRI test in these four indices (P ＞ 0.05).No significant difference on accuracy and predictive value was seen in subgroup analysis according to tumor size,tumor grade,hormone receptor and HER2 status between the two examinations.The sensitivity and specificity of ultrasound associated with MRI test were 70.6％ and 97.2％.Conclusions The accuracy and predictive value between preoperative ultrasound exam and MRI is comparable.Ultrasound associated with MRI examination can achieve high specificity,which may spare a portion of patients free from sentinel lymph nodes biopsy.
