CAJ | 학술논문

目的探讨乳腺癌超声征象联合肿瘤组织血管内皮生长因子( VEGF)-C在老年乳腺癌腋窝淋巴结转移中的诊断价值. 方法选择老年乳腺癌患者50 例,利用免疫组织化学染色检测标本中VEGF-C的表达水平,分析乳腺癌超声征象与 VEGF-C 表达与乳腺癌患者腋窝淋巴结状态. 结果 50例老年乳腺癌患者中,腋窝淋巴结转移28例,未转移22例,乳腺癌病灶最小为0.7 cm×0.6 cm,最大为7.0 cm×6.3 cm;其中大于2 cm的35例,具有较为典型的恶性肿瘤超声特征,表现为形态不规则的较低回声区,呈"蟹足样",无包膜回声,后方回声衰减,内部回声不均匀;肿瘤>2 cm患者淋巴结转移率明显高于肿瘤≤2 cm者,肿瘤边界不清楚或有毛刺者淋巴结转移率明显高于肿瘤边界清楚者( P<0.05 );乳腺癌患者病灶内超声血流信号分级越低,乳腺癌病灶越小( P<0.05 );乳腺癌患者病灶内超声血流信号分级越高,乳腺癌患者腋窝淋巴结转移率越高( P<0.05 );50 例乳腺癌患者中VEGF-C表达阳性28例,其中淋巴结转移者24 例,乳腺癌淋巴结转移患者 VEGF-C 阳性表达率明显高于乳腺癌淋巴结未转移患者( P<0.05 ).结论乳腺癌腋窝淋巴结转移主要表现为淋巴结结构的改变,当腋窝淋巴结发生实变、实质厚度不均时,可疑为转移性淋巴结,老年乳腺癌超声肿瘤内彩色血流信号丰富程度及VEGF-C阳性表达率与腋窝淋巴结发生转移密切相关.
목적 탐토유선암초성정상연합종류조직혈관내피생장인자( VEGF)-C재노년유선암액와림파결전이중적진단개치. 방법 선택노년유선암환자50 례,이용면역조직화학염색검측표본중VEGF-C적표체수평,분석유선암초성정상여 VEGF-C 표체여유선암환자액와림파결상태. 결과 50례노년유선암환자중,액와림파결전이28례,미전이22례,유선암병조최소위0.7 cm×0.6 cm,최대위7.0 cm×6.3 cm;기중대우2 cm적35례,구유교위전형적악성종류초성특정,표현위형태불규칙적교저회성구,정"해족양",무포막회성,후방회성쇠감,내부회성불균균;종류>2 cm환자림파결전이솔명현고우종류≤2 cm자,종류변계불청초혹유모자자림파결전이솔명현고우종류변계청초자( P<0.05 );유선암환자병조내초성혈류신호분급월저,유선암병조월소( P<0.05 );유선암환자병조내초성혈류신호분급월고,유선암환자액와림파결전이솔월고( P<0.05 );50 례유선암환자중VEGF-C표체양성28례,기중림파결전이자24 례,유선암림파결전이환자 VEGF-C 양성표체솔명현고우유선암림파결미전이환자( P<0.05 ).결론 유선암액와림파결전이주요표현위림파결결구적개변,당액와림파결발생실변、실질후도불균시,가의위전이성림파결,노년유선암초성종류내채색혈류신호봉부정도급VEGF-C양성표체솔여액와림파결발생전이밀절상관.
Objective To explore the ultrasonic manifestations of breast cancer combined with tumor vascular endothelial growth fac-tor C( VEGF-C) to assess the diagnostic value of the axillary lymph node metastasis of breast cancer for the elderly.Methods 50 old pa-tients with breast cancer were selected.Immunohistochemical staining test was used to detect the expression of VEGF-C,clinical values of ul-trasonic manifestations of breast cancer and the expression of VEGF-C for axillary lymph node status in patients with breast cancer were ana-lyzed.Results Among 50 cases of elderly patients with breast cancer,there were 28 cases of axillary lymph node metastases,22 cases with-out axillary lymph node metastases.Breast cancer minimum lesions was 0.7 cm×0.6 cm,the maximum was 7.0 cm×6.3 cm.There were 35 cases whose lesion was larger than 2 cm,and with a relatively typical sonographic features of malignancy,showed the irregular form was keyed acoustic area,a"crab pattern",no coated echoes,rear echo attenuation,echogenicity,uneven.Lymph node metastasis rate of lesion >2 cm was significantly higher than that of the tumor≤2 cm.Lymph node metastasis rate of the tumor boundary unclear or with burr was significant-ly higher than that of the tumor boundary clear(P<0.05).Lower grade of breast cancer lesions ultrasound blood flow signals,the smaller the breast lesions( P<0.05) .Higher grade of breast cancer lesions ultrasound blood flow signals, higher the rate of lymph node metastasis( P<0. 05).There were 28 patients with positive expression of VEGF-C,including 24 cases with lymph node metastasis.VEGF-C positive expression rate of lymph node metastasis was significantly higher than that of patients with without lymph node metastasis(P<0.05).Conclusions Ax-illary lymph node metastasis of breast cancer is mainly characterized by changes in the structure of lymph nodes,consolidation occurs when the axillary lymph nodes,uneven thickness of substance,suspicious for metastatic lymph nodes.Senile breast cancer tumors of ultrasonic color doppler signal richness and VEGF-C positive expression rate are closely related to the axillary lymph node metastasis.