Wang Jue, Ben Zhifei, Gao Shanshan, Lyu Shuyi, Wei Xiuzhi
Department of Ultrasound, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.
Department of Interventional Therapy, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.
Gland Surg. 2021 Apr;10(4):1460-1469. doi: 10.21037/gs-21-199.
This study examined the effects of different ultrasound imaging technologies in the identification and prediction of axillary lymph node metastasis of breast cancer. It also investigated the relationship between human papilloma virus (HPV) infection and axillary lymph node metastasis.
Eighty-five female patients diagnosed with breast masses participated in this study. Each patient underwent a conventional ultrasound, ultrasonic elastography, and virtual touch tissue imaging quantification (VTIQ). The differential diagnosis efficiency of a conventional ultrasound, ultrasound elastography, VTIQ, and ultrasound elastography combined with VTIQ technology was compared with a pathological diagnosis, which represents the gold standard. 85 axillary lymph node tissues and 25 normal breast tissues were used to detect HPV positive infection rate differences in different tissues.
The results showed that metastatic lymph nodes and reactive lymph node hyperplasia accounted for 54.12% and 45.88% of the 85 axillary lymph nodes of breast cancer, respectively. The conventional ultrasound, ultrasound elastography, and VTIQ scores of metastatic lymph nodes were significantly higher than those of reactive lymph node hyperplasia (P<0.05). The diagnostic sensitivity (Se) (91.30%), specificity (Sp) (92.31%), accuracy (Ac) (91.76%), positive predictive value (PPV) (93.33%), and negative predictive value (NPV) (90.00%) of ultrasound elastography combined with VTIQ technology were the highest among the diagnostic efficiency test results of different computer ultrasound imaging technologies. The positive infection rate of HPV in metastatic lymph node tissues was significantly higher than that in reactive lymph node hyperplasia and normal breast tissues (P<0.05).
Combining ultrasound elastography with VTIQ technology has high value in the differential diagnosis of axillary lymph nodes of breast cancer. Further, it appears that HPV infection may have an etiological role in lymph node metastasis in breast cancer patients.
本研究探讨了不同超声成像技术在乳腺癌腋窝淋巴结转移的识别与预测中的作用。同时，还研究了人乳头瘤病毒（HPV）感染与腋窝淋巴结转移之间的关系。
85例诊断为乳腺肿块的女性患者参与了本研究。每位患者均接受了常规超声、超声弹性成像及虚拟触诊组织成像定量（VTIQ）检查。将常规超声、超声弹性成像、VTIQ以及超声弹性成像联合VTIQ技术的鉴别诊断效率与作为金标准的病理诊断进行比较。采用85个腋窝淋巴结组织和25个正常乳腺组织检测不同组织中HPV阳性感染率的差异。
结果显示，在85个乳腺癌腋窝淋巴结中，转移淋巴结和反应性淋巴结增生分别占54.12%和45.88%。转移淋巴结的常规超声、超声弹性成像及VTIQ评分显著高于反应性淋巴结增生（P<0.05）。在不同计算机超声成像技术的诊断效率测试结果中，超声弹性成像联合VTIQ技术的诊断敏感性（Se）（91.30%）、特异性（Sp）（92.31%）、准确性（Ac）（91.76%）、阳性预测值（PPV）（93.33%）和阴性预测值（NPV）（90.00%）最高。转移淋巴结组织中HPV的阳性感染率显著高于反应性淋巴结增生和正常乳腺组织（P<0.05）。
超声弹性成像联合VTIQ技术在乳腺癌腋窝淋巴结的鉴别诊断中具有较高价值。此外，HPV感染似乎在乳腺癌患者淋巴结转移中具有病因学作用。
