Wang Jundong, Lu Xiaoli, Zheng Xuan, Xia Congyan, Li Ping
Department of Ultrasound, Nanjing First Hospital, Jiangsu Province, China.
J Oncol. 2022 May 14;2022:2590647. doi: 10.1155/2022/2590647. eCollection 2022.
To explore the clinical value of preoperative ultrasound signs in evaluating axillary lymph node status in triple-negative breast cancer (TNBC).
A retrospective study was conducted on 162 patients with TNBC who were admitted to our hospital from January 2017 to June 2021. A total of 62 patients with axillary lymph node metastasis and 100 patients with normal axillary lymph nodes were included. Univariate and logistic regression was used to analyze the correlation between clinicopathological parameters, ultrasound features, and axillary lymph node metastasis between these two groups. The receiver operating characteristic (ROC) curve of each index was drawn to predict positive axillary lymph node.
The lymph node positive rate was higher in patients with tumor size (2 mm < ≤ 5 mm) and tumor stage III, and the difference between these two groups was statistically significant ( < 0.05). The patients with cortical thickness ≥ 3, blood flow grades II-III, aspect ratio (L/S) ≥ 2, and RI ≥ 0.7 had higher lymph node positive rate, and the difference between these two groups was statistically significant ( < 0.05). Other index shows no correlation with ancillary lymph node positive rate, or the correlation was not statistically significant ( > 0.05). Further regression analysis indicated that the blood flow grade and L/S of axillary lymph nodes were independent influencing factors of axillary lymph node metastasis in TNBC patients ( < 0.05). Relevant receiver operating characteristic (ROC) curves were constructed, and the AUC of axillary lymph node blood flow grade and L/S for predicting axillary lymph node status was 0.6329 and 0.6498, respectively. The AUC for the joint prediction of the two indicators is 0.6898.
Ultrasound sign combined with clinicopathological characteristics can predict the axillary lymph nodes metastasis in TNBC, which could guide clinical decision of axillary lymph node surgery.
探讨术前超声征象在评估三阴性乳腺癌（TNBC）腋窝淋巴结状态中的临床价值。
对2017年1月至2021年6月我院收治的162例TNBC患者进行回顾性研究。共纳入62例腋窝淋巴结转移患者和100例腋窝淋巴结正常患者。采用单因素和逻辑回归分析两组患者临床病理参数、超声特征与腋窝淋巴结转移之间的相关性。绘制各指标的受试者操作特征（ROC）曲线以预测腋窝淋巴结阳性。
肿瘤大小（2mm＜ ≤5mm）和肿瘤分期为Ⅲ期的患者淋巴结阳性率较高，两组间差异有统计学意义（ ＜0.05）。皮质厚度≥3、血流分级为Ⅱ - Ⅲ级、纵横比（L/S）≥2及阻力指数（RI）≥0.7的患者淋巴结阳性率较高，两组间差异有统计学意义（ ＜0.05）。其他指标与腋窝淋巴结阳性率无相关性，或相关性无统计学意义（ ＞0.05）。进一步回归分析表明，腋窝淋巴结血流分级和L/S是TNBC患者腋窝淋巴结转移的独立影响因素（ ＜0.05）。构建相关的受试者操作特征（ROC）曲线，腋窝淋巴结血流分级和L/S预测腋窝淋巴结状态的曲线下面积（AUC）分别为0.6329和0.6498。两项指标联合预测的AUC为0.6898。
超声征象联合临床病理特征可预测TNBC腋窝淋巴结转移，可为腋窝淋巴结手术的临床决策提供指导。
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