Sianesi Mario, Ceci Guido, Ghirarduzzi Andrea, Del Rio Paolo, Guazzi Anna, Pisanelli Beatrice, Martella Eugenia, Ardizzoni Andrea, Di Blasio Beatrice, Arcuri Maria Francesca
Department of Surgical Science, General Surgery and Organ transplantation, University of Parma, Parma, Italy.
Ann Ital Chir. 2009 Jul-Aug;80(4):315-8.
The lymph node sentinel method is today used for staging the axillary lymph node stations. Ultrasonography is widely available and inexpensive method to study axillary status.
One hundred fourteen patients were studied consecutively using axillary ultrasonography and ultrasound guided fine needle aspiration of the lymph node. We used ATL Ultramark 9 with 5-7.5 MHz multiple frequency linear probe or Aloka SSDD-1400 with 7.5 MHz linear probe.
One hundred fourteen patients were examined; six were excluded because of definitive histological diagnosis of non-infiltrating carcinoma. 106 had monofocal carcinomas, 2 had bifocal carcinoma in 104/108 ultrasonography was carried out successfully. The axillary cytological examination was positive in 18 cases (17.3%) who were subjected to axillary examination. 86 patients were subjected to sentinel lymph node biopsy: positive 13 cases (6 micrometastases). 31 cases/104 (29.8%) showed positive axilla. Sensitivity of ultrasonography was 58%, 100%specificity. Predictive positive value 100%, Negative value 84.9% for an accuracy of 87.5%.
Ultrasonography is useful in all cases eligible to sentinel lymph node examination; the minimum cost of the procedure and of the human resources is amply rewarded by the direct indication for surgical axillary dissection in case of a positive result (17.3% in our experience).
淋巴结前哨方法如今用于腋窝淋巴结分期。超声检查是研究腋窝状况广泛可用且廉价的方法。
连续对114例患者使用腋窝超声检查及超声引导下淋巴结细针穿刺。我们使用配备5 - 7.5MHz多频率线性探头的ATL Ultramark 9或配备7.5MHz线性探头的Aloka SSDD - 1400。
检查了114例患者；6例因非浸润性癌的确切组织学诊断而被排除。106例有单灶性癌，2例有双灶性癌，104/108例成功进行了超声检查。接受腋窝检查的18例（17.3%）腋窝细胞学检查呈阳性。86例患者接受了前哨淋巴结活检：13例阳性（6例微转移）。104例中有31例（29.8%）腋窝呈阳性。超声检查的敏感性为58%，特异性为100%。预测阳性值为100%，阴性值为84.9%，准确率为87.5%。
超声检查对所有适合前哨淋巴结检查的病例均有用；该检查及人力资源的最低成本因结果阳性时直接指示进行腋窝手术清扫而得到充分回报（我们的经验中为17.3%）。
