Nowikiewicz Tomasz, Nowak Adam, Wiśniewska Magdalena, Wiśniewski Michał, Nowikiewicz Magdalena, Zegarski Wojciech
Chair and Department of Surgical Oncology, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.
Department of Breast Cancer and Reconstructive Surgery, Prof. Franciszek Łukaszczyk Oncology Centre, Bydgoszcz, Poland.
Contemp Oncol (Pozn). 2018;22(4):247-251. doi: 10.5114/wo.2018.82644. Epub 2018 Dec 31.
Properly planned and performed diagnostic tests allow the optimal treatment option to be chosen for the patient. They also allow qualification for the correct surgical procedure.
In this study we evaluated the clinical value of preoperative ultrasound scan (USS) testing performed during primary disease staging in patients with early breast cancer qualified to sentinel lymph node biopsy (SLNB).
The group of breast cancer patients who underwent SLNB from March 2012 to May 2013. As well as the standard procedure of the preoperative diagnostics model, in each patient the USS of axillary lymph nodes was performed additionally. The results were compared with the data from postoperative pathological reports. We attempted to define the factors influencing the possibility of obtaining false positive and false negative USS results.
The analysis comprised 172 patients. In 14.4% of cases with normal USS result the pathological result was different from the expected one (pN1). In 42.3% of patients with suspicious axillary lymph nodes the result of the pathological report was positive. The sensitivity of the USS testing was 89.3%, and the specificity was 34.4%, PPV - 85.6%, NPV - 42.3%.
Ultrasonographic assessment of axillary lymph nodes in breast cancer patients qualified for SLNB is a test with high sensitivity and high predictive value of the positive test result. The possibility of a result contrary to the actual nodal status may result primarily from the technical limitations of USS testing.
精心规划和实施的诊断测试有助于为患者选择最佳治疗方案，还能确定适合的手术程序。
本研究评估了在早期乳腺癌患者进行前哨淋巴结活检（SLNB）的原发性疾病分期过程中进行术前超声扫描（USS）测试的临床价值。
研究对象为2012年3月至2013年5月期间接受SLNB的乳腺癌患者组。除了术前诊断模型的标准程序外，还对每位患者额外进行了腋窝淋巴结的超声扫描。将结果与术后病理报告的数据进行比较。我们试图确定影响超声扫描结果出现假阳性和假阴性可能性的因素。
分析纳入了172例患者。超声扫描结果正常的病例中，有14.4%的病理结果与预期不同（pN1）。腋窝淋巴结可疑的患者中，42.3%的病理报告结果为阳性。超声扫描测试的敏感性为89.3%，特异性为34.4%，阳性预测值（PPV）为85.6%，阴性预测值（NPV）为42.3%。
对于适合进行SLNB的乳腺癌患者，腋窝淋巴结的超声评估是一项具有高敏感性和高阳性测试结果预测价值的检查。结果与实际淋巴结状态不符的可能性可能主要源于超声扫描测试的技术局限性。
