超声弹性成像联合二维超声、CDFI多元分析超声预测乳腺癌腋窝淋巴结转移价值

发布时间：2018-07-22 21:11

【摘要】：目的：探讨二维超声(two-dimensional ultrasound,2D-US)、彩色多普勒血流成像(color doppler flow imaging, CDFI)和超声弹性成像(ultrasonic elastography,UE)预测乳腺癌腋窝淋巴结(axillary lymph node,ALN)转移的临床价值。方法：对2012年12月至2015年1月广西医科大学第一附属医院胃肠腺体外科收治的145例女性乳腺癌患者,同侧145枚ALN进行2D-US、 CDFI及UE检查,145枚ALN均有病理诊断作为金标准。2D-US记录ALN大小、形态、内部回声,CDFI对ALN血流进行分型,UE对ALN进行弹性评分。用淋巴结2D-US、CDFI、UE声像特征建立Logistic回归模型,对超声预测乳腺癌ALN转移的价值进行研究,并比较分析超声指标诊断乳腺癌ALN转移的准确性。结果：以ALN病理诊断为因变量,淋巴结2D-US、CDFI、UE各参数为自变量,创建单因素Logistic回归模型显示淋巴结L/S2.00、形态Ⅱ型、形态Ⅲ型、血流Ⅲ型、弹性评分4分是预测淋巴结转移的危险因素,其Logistic回归系数(Logistic regression coefficient,β)均0,优势比(Odds ratio, OR)均1。多因素Logistic回归分析淋巴结血流Ⅲ型、弹性评分4分是淋巴结转移的高风险因素,其β分别为1.498、2.536,OR分别为4.474、12.633。以ALN超声指标：L/S2.00、形态(Ⅱ型、Ⅲ型)、血流Ⅲ型、弹性评分≥3分为界值及联合多因素分析的高风险指标(血流Ⅲ型+弹性评分4分)诊断乳腺癌ALN转移的准确度分别为69.66%、79.31%、70.34%、82.07%、85.52%。弹性评分≥3分诊断ALN转移的准确度均高于各单项超声指标,比较差异有统计学意义(P0.05)。联合高风险指标预测ALN转移的准确度均高于其余各项超声指标,比较差异有统计学意义(P0.05)。结论：淋巴结血流Ⅲ型、超声弹性评分4分是乳腺癌ALN转移的重要危险因素,弹性评分≥3分诊断ALN转移准确度均高于2D-US和CDFI检测,UE是评价乳腺癌ALN转移有临床价值的新方法,超声多因素综合分析可以提高术前预测乳腺癌ALN转移风险的准确性。
[Abstract]:Objective: to evaluate the clinical value of two-dimensional ultrasound 2D-US, color Doppler flow imaging (color doppler flow imaging, CDFI) and ultrasonic elastography (UE) in predicting the metastasis of (axillary lymph node ALN in breast cancer. Methods: from December 2012 to January 2015, 145 female patients with breast cancer were treated in Gastrointestinal gland surgery, the first affiliated Hospital of Guangxi Medical University. All 145 ALN on the ipsilateral side were examined by 2D-US.145 ALN were examined by CDFI and UE. Pathological diagnosis was used as gold standard .2D-US to record the size and morphology of ALN. The blood flow of ALN was classified by CDFI with internal echo and UE was used to evaluate the elasticity of ALN. Logistic regression model was established by using 2D-USP CDFIU UE features of lymph nodes to study the value of ultrasonography in predicting ALN metastasis of breast cancer and to compare and analyze the accuracy of ultrasonography in diagnosis of ALN metastasis in breast cancer. Results: based on the pathological diagnosis of ALN and the parameters of CDFIUE in lymph node 2D-USFIUE, a univariate logistic regression model was established to show that the lymph node L / S2.00, shape 鈪，

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