| 张 毅,张 颖,袁 梅,郑淑芳,王 伟,周亚丽,李文晓,王海波.彩色多普勒超声赋分诊断三阴性乳腺癌并腋淋巴结转移的临床研究[J].,2017,17(26):5066-5073 |
| 彩色多普勒超声赋分诊断三阴性乳腺癌并腋淋巴结转移的临床研究 |
| Clinical Research of Color Doppler Ultrasound Assign Points Diagnosis for Triple-Negative Breast Cancer and Axillary Lymph Node Metastasis |
| 投稿时间：2016-11-23 修订日期：2016-12-20 |
| DOI：10.13241/j.cnki.pmb.2017.26.014 |
| 中文关键词: 受体/雌激素 孕酮 人表皮生长因子-2 乳腺肿瘤 彩色多普勒超声 赋分诊断 |
| 英文关键词: Estrogen receptor Progesterone receptor Human epidermal growth factorreceptor-2 Breast tumor Color Doppler ultrasound Assign points diagnosis |
| 基金项目:山东省科学技术发展计划项目（2011GGB 01274） |
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| 中文摘要: |
| 摘要 目的：探讨彩色多普勒超声（CDU）赋分诊断(HER-2、ER和PR)三阴性乳腺癌（TNBC）并腋淋巴结转移（ALNM）的临床应用价值。方法：回顾性分析2014年1月至2015年12月期间在青岛大学附属医院经CDU检查、手术和病理证实的863例女性乳腺癌患者的临床资料。根据临床病理学及免疫组化(的)检测结果(将其)分为TNBC组和非三阴性乳腺癌（NTNBC）组。对比分析两组乳腺癌的CDU征象，采用多因素非条件Logistic回归分析CDU赋分诊断与TNBC的相关性。将CDU描述性指标纳入赋分（0~15分），赋分＞10分者为NTNBC，8~10分为疑似TNBC，＜8分为倾向TNBC。结果：本组乳腺癌CDU诊断与病理符合率为90.96%（785/863），删除不能确定乳腺肿块性质78例（9.04%）。NBC组（105例）与NTNBC组（680例），肿块呈圆形或椭圆形（48.57% vs10.70%）、最大径＞5.0 cm（21.90%vs15.30%）、无微钙化灶（87.62%vs74.12%）、境界清楚（56.19%vs41.47%）、边缘无毛刺征（74.29%vs41.62%）、周边无高回声晕环（74.29%vs46.76%）、后方回声无衰减（72.38%vs46.76%）、ALNM（61.90%vs 37.35%）等比较有明显差异（P＜0.05），而在肿块数目、纵横径比、回声程度、回声分布和血流分级等则无明显差异（P＞0.05）。CDU赋分＞10分为NTNBC与病理符合率93.93%（680/724）；8~10分疑似诊断TNBC符合率11.51%（16/139）；＜8分倾向诊断TNBC符合率64.03%（89/139），TNBC总诊断符合率为75.54%（105/139）。在CDU诊断785例乳腺癌中，ALN肿大319例(40.64%)，其中TNBC组61.90%（65/105），NTNBC组37.35%（254/680）。经多因素非条件Logistic回归分析结果显示：肿块呈圆形或椭圆形、边缘无毛刺征、周边无高回声晕环、后方回声无衰减和ALNM等与TNBC存在相关性（P＜0.05）。结论：乳腺貌似良性肿块并腋淋巴结肿大，CDU赋分＜8分，同时年龄≤50岁或未绝经，或有乳腺癌家族易感史者，可作为CDU诊断TNBC 并ALNM重要参考指标，具有较高的临床应用价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore clinical application value of color Doppler ultrasound (CDU) assigned to diagnose triple-negative breast cancer (TNBC) and axillary lymph node metastasis (ALNM). Methods: A retrospectively analyzed of proved of clinical data on the 863 patients breast cancer in women by CDU inspection, operation and pathology. According results will be divided into TNBC group and non negative breast cancer (NTNBC) group via clinical pathological and immunohistochemical detection. Using multi-factor unconditioned Logistic regression analysis the CDU supposed the diagnosis and the correlation of TNBC. Results: The coincidence rate of CDU and pathological diagnosis was 90.96% (785/863), 78 cases (9.04%) remove breast masses, 105 patients TNBC group and NTNBC group 680 patients. The mass circular or elliptic (48.57% vs10.70 %) , the tumor maximum diameter 5.0 cm (21.90% vs 15.30 %), micro calcifications (87.62% vs 74.12 %), state clearly (56.19% vs 41.47 %), no burr edge character (74.29% vs 41.62 %), peripheral hyperechoic halo ring (74.29% vs46.76 %), rear echo attenuation (72.38% vs 46.76 %), no ALNM (61.90% vs 37.35%) comparing the two groups exists significant difference (P< 0.05), while the mass number, and vertical and horizontal diameter ratio, degree of echo, echo distribution and blood flow classification comparing the two groups were no significant difference (P> 0.05). The CDU fu points > 10 divided into NTNBC and pathological coincidence rate 93.93% (680/724), 8 ~ 10 points TNBC suspected diagnosis coincidence rate 11.51% (16/139),< 8 points TNBC tendency diagnosis coincidence rate 64.03% (89/139), TNBC total diagnostic coincidence rate was 75.54% (105/139). In CDU diagnosed 785 cases of breast cancer, the ALN enlargement in 319 cases (40.64%), with TNBC group was 61.90% (65/105), NTNBC group was 37.35% (254/680). Logistic regression analysis results: tumor assumes the circular or elliptic, edge without burr, peripheral hyperechoic halo ring, rear echo attenuation and ALNM with TNBC has certain correlation (P<0.05). Conclusion: The seemingly benign breast diseases and axillary lymph node enlargement, the CDU, supposed less than 8 points, age 50 or less or not at the same time, menopause or having a history of breast cancer susceptibility to family, important reference index, clinical value has high of CDU diagnostic of TNBC and ALNM. |
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