中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2014年
12期
924-928
,共5页
辛灵%陈路增%张虹%刘倩%徐玲%王彬%李挺%段学宁%刘荫华
辛靈%陳路增%張虹%劉倩%徐玲%王彬%李挺%段學寧%劉蔭華
신령%진로증%장홍%류천%서령%왕빈%리정%단학저%류음화
乳腺肿瘤%超声检查%前哨淋巴结活组织检查%病理学
乳腺腫瘤%超聲檢查%前哨淋巴結活組織檢查%病理學
유선종류%초성검사%전초림파결활조직검사%병이학
Breast neoplasms%Ultrasonography%Sentinel lymph node biopsy%Pathology
目的 回顾性研究超声检查对乳腺癌腋窝淋巴结转移的诊断价值;分析腋窝淋巴结转移乳腺癌的临床病理特征.方法 回顾性分析2012年6月至2013年6月收治的323例新发女性浸润性乳腺癌患者的临床资料,中位年龄54岁,全部接受腋窝淋巴结超声检查及病理检查.以组织病理学诊断为金标准分析超声检查对乳腺癌患者腋窝淋巴结转移的诊断价值,并依据2013年St.Gallen专家共识进行分子分型,利用x2检验探讨腋窝淋巴结转移乳腺癌的临床病理特点.结果 超声评价腋窝淋巴结转移灵敏度为35.6％ (46/129),特异度为98.9％ (181/183),阳性预测值为95.8％ (46/48),阴性预测值为68.6％ (181/264).入组患者Luminal A-like型11.2％(36/323),Luminal B-like型58.5％(189/323),人类表皮生长因子受体2过表达型13.3％(43/323),三阴型17.0％(55/323).单因素分析结果显示,腋窝淋巴结转移与月经状态、原发肿瘤T分期相关(x2=4.337、11.100,P=0.037、0.001),与原发肿瘤分子分型无明显相关性.结论 超声检查对诊断腋窝淋巴结状态具有一定价值,前哨淋巴结活检是腋窝淋巴结临床分期的重要补充.乳腺癌腋窝淋巴结转移与月经状态、肿瘤T分期具有相关性,与分子分型无明显相关性.
目的 迴顧性研究超聲檢查對乳腺癌腋窩淋巴結轉移的診斷價值;分析腋窩淋巴結轉移乳腺癌的臨床病理特徵.方法 迴顧性分析2012年6月至2013年6月收治的323例新髮女性浸潤性乳腺癌患者的臨床資料,中位年齡54歲,全部接受腋窩淋巴結超聲檢查及病理檢查.以組織病理學診斷為金標準分析超聲檢查對乳腺癌患者腋窩淋巴結轉移的診斷價值,併依據2013年St.Gallen專傢共識進行分子分型,利用x2檢驗探討腋窩淋巴結轉移乳腺癌的臨床病理特點.結果 超聲評價腋窩淋巴結轉移靈敏度為35.6％ (46/129),特異度為98.9％ (181/183),暘性預測值為95.8％ (46/48),陰性預測值為68.6％ (181/264).入組患者Luminal A-like型11.2％(36/323),Luminal B-like型58.5％(189/323),人類錶皮生長因子受體2過錶達型13.3％(43/323),三陰型17.0％(55/323).單因素分析結果顯示,腋窩淋巴結轉移與月經狀態、原髮腫瘤T分期相關(x2=4.337、11.100,P=0.037、0.001),與原髮腫瘤分子分型無明顯相關性.結論 超聲檢查對診斷腋窩淋巴結狀態具有一定價值,前哨淋巴結活檢是腋窩淋巴結臨床分期的重要補充.乳腺癌腋窩淋巴結轉移與月經狀態、腫瘤T分期具有相關性,與分子分型無明顯相關性.
목적 회고성연구초성검사대유선암액와림파결전이적진단개치;분석액와림파결전이유선암적림상병리특정.방법 회고성분석2012년6월지2013년6월수치적323례신발녀성침윤성유선암환자적림상자료,중위년령54세,전부접수액와림파결초성검사급병리검사.이조직병이학진단위금표준분석초성검사대유선암환자액와림파결전이적진단개치,병의거2013년St.Gallen전가공식진행분자분형,이용x2검험탐토액와림파결전이유선암적림상병리특점.결과 초성평개액와림파결전이령민도위35.6％ (46/129),특이도위98.9％ (181/183),양성예측치위95.8％ (46/48),음성예측치위68.6％ (181/264).입조환자Luminal A-like형11.2％(36/323),Luminal B-like형58.5％(189/323),인류표피생장인자수체2과표체형13.3％(43/323),삼음형17.0％(55/323).단인소분석결과현시,액와림파결전이여월경상태、원발종류T분기상관(x2=4.337、11.100,P=0.037、0.001),여원발종류분자분형무명현상관성.결론 초성검사대진단액와림파결상태구유일정개치,전초림파결활검시액와림파결림상분기적중요보충.유선암액와림파결전이여월경상태、종류T분기구유상관성,여분자분형무명현상관성.
Objectives To evaluate the value of ultrasound (US) in predicting axilla status and to investigate the clinic pathologic characters in the axillary node metastasis.Methods From June 2012 to June 2013,323 female primary breast cancer patients who received both axilla ultrasound and pathology examinations were reviewed retrospectively.The features of axillary nodes including diameter,longitudinaltransverse axis ratio,cortical thickness and blood flow grade were used to evaluate axillary status.US accuracy of axillary node metastasis was analyzed correlated with the final pathology results.The clinical and histological features associated with axillary node metastasis was analyzed by x2 test.Results The proportions of Luminal A-like,Luminal B-like,human epidermalgrowth factor receptor-2 positive and triple negative breast cancer were 11.1％ (36/323),58.5％ (189/323),13.3％ (43/323) and 17.0％ (55/ 323).The sensitivity,specificity,positive predictive value and negative predictive value of axilla US in the diagnosis of nodal metastasis were 35.6％ (46/129),98.9％ (181/183),95.8％ (46/48) and 68.6％ (181/264).Axillary lymph node metastasis had statistically significant correlation with menopausal status and clinical tumor size (x2 =4.337,11.100 ; P =0.037,0.001).Conclusions Standardized ultrasound is the basic way to evaluate axilla status.Sentinel lymph node biopsy should be done to acquire accurate preoperative staging of axilla when US shows no signs of metastasis.Axillary lymph node metastasis is significantly related to menopausal status and clinical tumor size,but not significantly related to subtype classification of primary breast cancer.
