Zhang Yan-Na, Wang Chang-Jun, Xu Ying, Zhu Qing-Li, Zhou Yi-Dong, Zhang Jing, Mao Feng, Jiang Yu-Xin, Sun Qiang
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Ultrasound Med Biol. 2015 Jul;41(7):1835-41. doi: 10.1016/j.ultrasmedbio.2015.03.024. Epub 2015 Apr 29.
The use of ultrasound in the diagnosis of axillary lymph node metastases from breast cancer in a Chinese population was investigated. Data for 1,049 with breast cancer were retrospectively collected. All patients had undergone pre-operative axillary ultrasound and then axillary lymph node dissection. The sensitivity, specificity and accuracy of axillary ultrasound in this cohort were 69.4%, 81.8% and 77.0%, respectively. The overall false-negative rate of ultrasound images was 30.6% (123/402). False-negative ultrasound rates for pathologic N1, N2 and N3 patients were 46.2%, 21.8% and 9.3%, respectively. In patients with stage T1 disease and fewer than three metastatic lymph nodes, the false-negative ultrasound rate was 52.2% (47/90). Moreover, breast cancer patients with a false-negative axillary ultrasound were more likely to have a large tumor (p < 0.001) and high tumor grade (p = 0.009). However, there were no statistically significant differences between accuracy of axillary ultrasound and age of patients or experiences of ultrasound practitioners. In conclusion, the sensitivity, specificity and accuracy of ultrasound in the diagnosis of breast cancer metastasis to the axillary lymph nodes in Chinese patients were assessed. These data could help us to carefully use axillary ultrasound to diagnose and predict breast cancer axillary lymph node metastasis.
研究了超声在中国人群乳腺癌腋窝淋巴结转移诊断中的应用。回顾性收集了1049例乳腺癌患者的数据。所有患者术前均接受了腋窝超声检查,随后进行了腋窝淋巴结清扫术。该队列中腋窝超声的敏感性、特异性和准确性分别为69.4%、81.8%和77.0%。超声图像的总体假阴性率为30.6%(123/402)。病理N1、N2和N3患者的超声假阴性率分别为46.2%、21.8%和9.3%。在T1期疾病且转移淋巴结少于3个的患者中,超声假阴性率为52.2%(47/90)。此外,腋窝超声假阴性的乳腺癌患者更有可能有较大肿瘤(p<0.001)和高肿瘤分级(p = 0.009)。然而,腋窝超声的准确性与患者年龄或超声从业者经验之间无统计学显著差异。总之,评估了超声在中国患者乳腺癌腋窝淋巴结转移诊断中的敏感性、特异性和准确性。这些数据有助于我们谨慎使用腋窝超声来诊断和预测乳腺癌腋窝淋巴结转移。