摘要
目的探讨超声造影(CEUS)+细针穿刺定位活检(FANB)对新辅助化疗后乳腺癌(BC)腋窝淋巴结(ALN)性质诊断效能的影响。方法选取河南省人民医院收治的疑似BC并发ALN转移患者87例(2017年8月至2020年8月),均接受FANB、CEUS检查。以ALN清扫术后病理诊断为“金标准”,记录FANB、CEUS及联合诊断结果,比较联合诊断与单一诊断灵敏度、准确度、特异度,并对比ALN转移阳性与阴性患者CEUS强化方式、造影强化时间、定量参数对比剂到达时间(AT)、达峰时间(TTP)、峰值强度(PI)、高灌注区与低灌注区差值(SImax-SImin)。结果87例疑似BC并发ALN转移患者经ALN清扫术后病理诊断证实ALN转移阳性患者80例,ALN转移阴性患者7例;CEUS联合FANB诊断的特异度、阳性预测值、阴性预测值与单一CEUS检查及FANB比较,差异无统计学意义(P>0.05),但CEUS联合FANB诊断的灵敏度、准确度显著高于单一CEUS检查及FANB,差异有统计学意义(P<0.05);ALN阳性患者与阴性患者CEUS强化方式比较,差异有统计学意义(P<0.05);ALN阳性与阴性患者AT、TTP、PI比较差异无统计学意义(P>0.05);ALN阳性患者造影强化时间长于阴性患者,SImax-SImin高于阴性患者(P<0.05)。结论CEUS+FANB应用于BC新辅助化疗后ALN性质诊断中具有较高灵敏度、准确度,其中CEUS检查时应着重观察强化方式、造影强化时间、SImax-SImin,可为临床改进治疗方案提供科学依据。
Objective To explore the effects of contrast-enhanced ultrasound(CEUS)+fine needle aspiration biopsy(FANB)on qualitative diagnostic efficiency of axillary lymph node(ALN)after neoadjuvant chemotherapy for breast cancer(BC).Methods A total of 87 patients with suspected BC complicated with ALN metastasis admitted to Henan Provincial People's Hospital from August 2017 to August 2020 were selected,and all were examined by FANB and CEUS.Taking pathological diagnosis after ALN dissection as the"gold standard",FANB,CEUS and the results of combined diagnosis were recorded to compare the sensitivity,accuracy and specificity of combined diagnosis and single diagnosis.CEUS enhancement method,contrast enhancement time,quantitative parameters,Arrival time of contrast agent(AT)and time to peak were compared between ALN metastasis positive and negative patients.TTP,Peak intensity(PI),the difference between high and low perfusion(Simax-simin).Results Of the 87 patients with suspected BC complicated with ALN metastasis after ALN dissection,pathological diagnosis showed that there were 80 cases with ALN metastasis and 7 cases without metastasis.The difference in diagnostic specificity,positive predictive value and negative predictive value between CEUS combined with FANB and single CEUS or FANB were not statistically significant(P>0.05).However,the sensitivity and accuracy of combined detection were significantly higher than those of CEUS and FANB alone(P<0.05).There were significant differences in enhancement methods of CEUS between between ALN positive patients and NEGATIVE patients(P<0.05),but there was no significant difference in AT,TTP or PI(P>0.05).Contrast enhancement time of ALN positive patients was longer than that of negative patients,and SiMAX-Simin was higher than that of negative patients(P<0.05).Conclusion CEUS+FANB has high sensitivity and accuracy in the diagnosis of ALN properties after BC neoadjuvant chemotherapy,in which the enhancement mode,contrast enhancement time and Simax-Simin should be observed during C
作者
周晓宁
徐爽
王丹
ZHOU Xiaoning;XU Shaung;WANG Dan(Department of Health Management,Henan Provincial People's Hospital,Zhengzhou Henan 450000,China;Department of Ultrasound,Zhengzhou Zhongkang Hospital,Zhengzhou Henan,450000,China)
出处
《临床研究》
2022年第7期161-164,共4页
Clinical Research
关键词
超声造影
乳腺癌
细针穿刺定位活检
新辅助化疗
诊断效能
contrast-enhanced ultrasound
breast cancer
fine needle aspiration biopsy
neoadjuvant chemotherapy
diagnostic efficiency
