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术前评估与超声造影引导下早期乳腺癌前哨淋巴结检测的影响因素:关键是什么。

Preoperative evaluation and influencing factors of sentinel lymph node detection for early breast cancer with contrast-enhanced ultrasonography: What matters.

机构信息

Breast Center.

Ultrasound Imaging Department, Zhongshan City People's Hospital, Guangdong Province, China.

出版信息

Medicine (Baltimore). 2021 Apr 2;100(13):e25183. doi: 10.1097/MD.0000000000025183.

DOI:10.1097/MD.0000000000025183
PMID:33787600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8021290/
Abstract

Sentinel lymph node (SLN) is important in the early diagnosis of breast cancer. We aimed to evaluate the role of contrast-enhanced ultrasonography (CEUS) in the preoperative evaluation for SLN and potentially influencing factors, to provide evidence to the management of breast cancer.Patients with breast cancer who treated in our hospital from May 2018 to May 2020 were selected. All patients underwent CEUS examination to find SLN and judged whether the lymph node had cancer metastasis. We evaluated the sensitivity, specificity, and accuracy of CEUS in predicting SLN, and its differences in pathological diagnosis results and related influencing factors were also analyzed.A total of 108 patients with breast cancer were included. And a total of 248 SLNs were detected. The sensitivity of CEUS to the preoperative evaluation of SLN was 84.67%, the specificity was 81.14%, the positive predictive value was 76.08%, and the negative predictive value was 89.27%, the positive likelihood ratio was 4.06, and the negative likelihood ratio was 0.14. The area under the curve of the preoperative evaluation of SLN in CEUS examination was 0.813 (95% confidence interval: 0.765-0.911), and there was significant difference in the size of SLNs between SLN-negative and SLN-positive groups (P = .043).Preoperative CEUS has good predictive value for the SLN detection in patients with breast cancer, and it is worthy of clinical application.

摘要

前哨淋巴结(SLN)在乳腺癌的早期诊断中很重要。我们旨在评估对比增强超声(CEUS)在 SLN 术前评估中的作用及其潜在影响因素,为乳腺癌的治疗提供依据。

选取 2018 年 5 月至 2020 年 5 月在我院治疗的乳腺癌患者。所有患者均接受 CEUS 检查以寻找 SLN,并判断淋巴结是否发生癌转移。我们评估了 CEUS 在预测 SLN 中的敏感性、特异性和准确性,并分析其与病理诊断结果的差异及其相关影响因素。

共纳入 108 例乳腺癌患者,共检测到 248 个 SLN。CEUS 对 SLN 术前评估的敏感性为 84.67%,特异性为 81.14%,阳性预测值为 76.08%,阴性预测值为 89.27%,阳性似然比为 4.06,阴性似然比为 0.14。CEUS 检查对 SLN 术前评估的曲线下面积为 0.813(95%置信区间:0.765-0.911),SLN 阴性组和 SLN 阳性组 SLN 大小差异有统计学意义(P=0.043)。

术前 CEUS 对乳腺癌患者 SLN 的检测具有良好的预测价值,值得临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3240/8021290/832ac51c0a1f/medi-100-e25183-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3240/8021290/644772dcb634/medi-100-e25183-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3240/8021290/832ac51c0a1f/medi-100-e25183-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3240/8021290/644772dcb634/medi-100-e25183-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3240/8021290/832ac51c0a1f/medi-100-e25183-g002.jpg

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