中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (01): 96-99.

• 论著 • 上一篇    下一篇

乳腺癌腋窝淋巴结B超检查特异性回顾性分析

刘    伟，李    越，赵    颖，曹旭晨，于治灏，王    欣   

  1. 天津医科大学附属肿瘤医院乳腺一科 乳腺癌防治教育部重点实验室 天津市“肿瘤防治”重点实验室，天津 300060
  • 出版日期:2011-01-01 发布日期:2011-05-30

  • Online:2011-01-01 Published:2011-05-30

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摘要：

目的    探讨各辅助检查方法对乳腺癌腋窝淋巴结转移的诊断价值。方法    对天津医科大学附属肿瘤医院2009年3月至2009年6月253例经手术病理证实乳腺癌病人术前B超与钼靶、MRI、PET-CT资料进行回顾性分析，比较灵敏度、特异度、阳性及阴性预测值和准确性。结果    B超（253例）灵敏度，特异度，阳性及阴性预测值，准确性为70.6%，87.4%，84.8%，75.0%和79.1%；钼靶（220例）为14.6%，100%，100%，53.9%和57.3%；MRI（27例）为50.0%，100%，100%，71.4%，77.8%；PET-CT（23例）为90.0%，92.3%，90.0%，92.3%，91.3%。B超与病理对照的Kappa值为0.581，与病理的一致性一般；高年资组B超医师的灵敏度、特异度、准确性为与低年资组比较差异有统计学意义（P＜0.05）。结论    判断乳腺癌腋窝淋巴结转移状况B超优于其他检查，而且超声检查者的经验影响诊断结果。

关键词: 乳腺癌, 腋窝淋巴结, 超声, 钼靶, MRI, PET-CT

Abstract:

New Evaluation of Ultrasonography for Axillary Lymph Node Metastasis in Breast Cancer        LIU Wei, LI Yue, ZHAO Ying, et al.
Corresponding author: WANG Xin, E-mail：xinwangse@126.com
The First Department of Breast Tumor, Tianjin Medical University Cancer Institute and Hospital. Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy,Tianjin, Tianjin 300060, China
Abstract    Objective    To reduce the postoperative complications of breast cancer and evaluate the value of ultrasonography in detecting ALN metastasis compared with mammography, MRI and PET-CT in patients with breast cancer. Methods   253 breast cancer patients who undergone ultrasonography were studied. The results of the histopathology after surgery were used as diagnostic golden standard. The findings of their sensitivity, specificity, positive predictive value, negative predictive value and accuracy in diagnosing axillary metastases lymph node of breast cancer were compared.  Results    The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by ultrasound were 70.6%, 87.4%, 84.8%, 75.0% and 79.1%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by mammography were 14.6%, 100%, 100%, 53.9% and 57.3%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by MRI were 50.0%, 100%, 100%, 71.4%, 77.8%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained by PET-CT were 90.0%, 92.3%, 90.0%, 92.3%, 91.3%. The Kappa value was 0.729. The sensitivity, specificity and accuracy of experienced doctors and un-experienced doctors were 69.2%, 87.1% and 78.1% ; 62.5 %, 88.2% and 75.8% respectively（P<0.05）.  Conclusion Our study indicates that ultrasonography is better than other examinations for predicting axillary node status, moreover the experiences of doctors affect the predicting results.

Key words: breast cancer, axillary node, ultrasonography, mammography, MRI, PET-CT