摘要
目的探讨浸润性乳腺癌原发病灶的灰阶超声特征及临床病理各参数与腋下淋巴结转移状态之间的相关性。方法回顾性分析335例浸润性乳腺癌患者的临床病理及超声资料，分为腋下淋巴结转移组和腋下淋巴结无转移组，分析原发灶的二维超声参数（包括方位、形状、边缘、后方回声、内部回声、钙化等因素）以及临床病理特征（包括大小、年龄、组织学分级及分子分型），用单因素（Chi—Square）和多因素（Logistic）分析临床病理特征、原发灶声像图各参数与腋下淋巴结转移的关系。结果单因素分析结果显示，患者年龄（〈45岁）、肿块大小（≥2era）、组织学分级（Ⅲ级）、分子分型（Luminal B）及边缘成角数（〉10个）对腋下淋巴结转移有影响，差异有统计学意义（均P〈0．05）。多因素Logistic回归分析结果显示，年龄（OR=0．573，P=0．019）、大小（OR=2．359，P=0．001）、组织学分级（OR=0．529，P=0．008）及边缘成角数（OR=1．889，P=0．031）为影响腋淋巴结转移的危险因素。结论乳腺癌声像图特征与腋下淋巴结转移存在相关性，结合临床病理资料，对判断腋下淋巴结转移有提示作用。
Objective To investigate the relationship of greyscale ultrasonographic signs and clinical pathological characteristics with axillary lymph node metastasis in invasive breast cancer. Methods Three hundred and thirty-five patients with pathologically confirmed breast cancer were retrospectively analyzed, which categorized into 2 groups, including lymph node metastasis group and lymph node non-metastasis group. The clinical and pathological characteristics included age, primary tumor size, histological grade, and molecular subtypes. The ultrasonographic features were examined including orientation, shape, margin, echo pattern, posterior acoustic feature, and calcification. Chi-Square test and Logistic regression analysis were performed to analyze the relationship of clinical pathological characteristics and greyscale ultrasonographic signs with axillary lymph node metastasis. Results Age （〈45 years）, primary tumor size （≥2 cm）, histological grade（ Ⅲ grade）, molecular subtype （Luminal B）, and number of margin angulation（〉10） contributed to axillary lymph node metastasis in 335 cases, according to univariate analysis （ P d0.05）. Multivariate Logistic regression analysis showed age （OR = 0.573, P = 0.019）, the primary tumor size （OR = 2. 359, P = 0. 001）, histological grade （OR = 0. 529, P = 0. 008）, and number of margin angulation （OR = 1. 889, P = 0. 031） were risk factors of axillary lymph node metastasis in breast cancer. Conclusions Uaivariate and multivariate analyses show the correlation between uhrasonographic features and axillary lymph node involvement. Combining with clinical pathological data, it can provide a predictor of axillary lymph node metastasis.
出处
《中华超声影像学杂志》
CSCD
北大核心
2017年第5期424-429,共6页
Chinese Journal of Ultrasonography
基金
国家自然科学基金面上项目（81371575）
国家重大科研仪器研制项目（81627804）
上海市卫生和计划生育委员会（201440424）
关键词
超声检查
浸润性乳腺癌
淋巴结转移
临床病理
Ultrasonography
Invasive breast cancer
Lymph node metastasis
Clinical pathology
