【摘要】：目的：探討二維超聲(two-dimensional ultrasound,2D-US)、彩色多普勒血流成像(color doppler flow imaging, CDFI)和超聲彈性成像(ultrasonic elastography,UE)預(yù)測(cè)乳腺癌腋窩淋巴結(jié)(axillary lymph node,ALN)轉(zhuǎn)移的臨床價(jià)值。方法：對(duì)2012年12月至2015年1月廣西醫(yī)科大學(xué)第一附屬醫(yī)院胃腸腺體外科收治的145例女性乳腺癌患者,同側(cè)145枚ALN進(jìn)行2D-US、 CDFI及UE檢查,145枚ALN均有病理診斷作為金標(biāo)準(zhǔn)。2D-US記錄ALN大小、形態(tài)、內(nèi)部回聲,CDFI對(duì)ALN血流進(jìn)行分型,UE對(duì)ALN進(jìn)行彈性評(píng)分。用淋巴結(jié)2D-US、CDFI、UE聲像特征建立Logistic回歸模型,對(duì)超聲預(yù)測(cè)乳腺癌ALN轉(zhuǎn)移的價(jià)值進(jìn)行研究,并比較分析超聲指標(biāo)診斷乳腺癌ALN轉(zhuǎn)移的準(zhǔn)確性。結(jié)果：以ALN病理診斷為因變量,淋巴結(jié)2D-US、CDFI、UE各參數(shù)為自變量,創(chuàng)建單因素Logistic回歸模型顯示淋巴結(jié)L/S2.00、形態(tài)Ⅱ型、形態(tài)Ⅲ型、血流Ⅲ型、彈性評(píng)分4分是預(yù)測(cè)淋巴結(jié)轉(zhuǎn)移的危險(xiǎn)因素,其Logistic回歸系數(shù)(Logistic regression coefficient,β)均0,優(yōu)勢(shì)比(Odds ratio, OR)均1。多因素Logistic回歸分析淋巴結(jié)血流Ⅲ型、彈性評(píng)分4分是淋巴結(jié)轉(zhuǎn)移的高風(fēng)險(xiǎn)因素,其β分別為1.498、2.536,OR分別為4.474、12.633。以ALN超聲指標(biāo)：L/S2.00、形態(tài)(Ⅱ型、Ⅲ型)、血流Ⅲ型、彈性評(píng)分≥3分為界值及聯(lián)合多因素分析的高風(fēng)險(xiǎn)指標(biāo)(血流Ⅲ型+彈性評(píng)分4分)診斷乳腺癌ALN轉(zhuǎn)移的準(zhǔn)確度分別為69.66%、79.31%、70.34%、82.07%、85.52%。彈性評(píng)分≥3分診斷ALN轉(zhuǎn)移的準(zhǔn)確度均高于各單項(xiàng)超聲指標(biāo),比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。聯(lián)合高風(fēng)險(xiǎn)指標(biāo)預(yù)測(cè)ALN轉(zhuǎn)移的準(zhǔn)確度均高于其余各項(xiàng)超聲指標(biāo),比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：淋巴結(jié)血流Ⅲ型、超聲彈性評(píng)分4分是乳腺癌ALN轉(zhuǎn)移的重要危險(xiǎn)因素,彈性評(píng)分≥3分診斷ALN轉(zhuǎn)移準(zhǔn)確度均高于2D-US和CDFI檢測(cè),UE是評(píng)價(jià)乳腺癌ALN轉(zhuǎn)移有臨床價(jià)值的新方法,超聲多因素綜合分析可以提高術(shù)前預(yù)測(cè)乳腺癌ALN轉(zhuǎn)移風(fēng)險(xiǎn)的準(zhǔn)確性。
[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，

本文編號(hào)：2138589