Iwamoto Naoko, Miyamoto Hiromi, Horiguchi Shinichiro, Honda Yayoi, Aruga Tomoyuki
Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
J Med Ultrason (2001). 2020 Apr;47(2):299-303. doi: 10.1007/s10396-020-01010-0. Epub 2020 Feb 29.
The American College of Surgeons Oncology Group (ACOSOG) Z1071 trial assessed the accuracy of sentinel lymph node biopsies in clinically node-positive patients who underwent neoadjuvant chemotherapy (NAC). Axillary ultrasound (US) images after NAC were reviewed, and the accuracy of classifying nodes into six types according to the ACOSOG Z1071 trial was determined.
This study included 69 patients who underwent NAC followed by curative surgery for breast cancer including axillary lymph node dissection between January 2010 and July 2019. All patients were pathologically confirmed as being initially node positive. Lymph nodes were retrospectively classified into one of six types based on the appearance of the nodal cortex and hilum. Types I and II were classified as having normal nodal morphology, whereas types III, IV, V, and VI were classified as having suspicious nodal morphology. These node types on US images after NAC were compared between patients with an axillary complete response (Ax-pCR) and those with residual metastatic lymph nodes (Ax-non-pCR) using Chi-square tests.
Twenty-four (35%) of the 69 patients achieved Ax-pCR. Patients with nodes classified as type I or II were more likely to achieve Ax-pCR (83% vs. 36%, p = 0. 0002).
The classification of six node types was associated with nodal status.
美国外科医师学会肿瘤学组（ACOSOG）Z1071试验评估了前哨淋巴结活检在接受新辅助化疗（NAC）的临床淋巴结阳性患者中的准确性。回顾了NAC后的腋窝超声（US）图像，并根据ACOSOG Z1071试验将淋巴结分为六种类型的准确性进行了测定。
本研究纳入了2010年1月至2019年7月期间接受NAC随后进行乳腺癌根治性手术（包括腋窝淋巴结清扫）的69例患者。所有患者经病理证实最初为淋巴结阳性。根据淋巴结皮质和门部的外观，将淋巴结回顾性地分为六种类型之一。I型和II型被分类为具有正常的淋巴结形态，而III型、IV型、V型和VI型被分类为具有可疑的淋巴结形态。使用卡方检验比较了腋窝完全缓解（Ax-pCR）患者和有残留转移性淋巴结（Ax-non-pCR）患者在NAC后US图像上的这些淋巴结类型。
69例患者中有24例（35%）实现了Ax-pCR。被分类为I型或II型淋巴结的患者更有可能实现Ax-pCR（83%对36%，p = 0.0002）。
六种淋巴结类型的分类与淋巴结状态相关。
