本文關(guān)鍵詞：B超預(yù)測(cè)乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的假陰性率及陰性預(yù)測(cè)值的影響因素　出處：《浙江大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：背景乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移是影響乳腺癌治療方案選擇及其預(yù)后的重要因素,故其術(shù)前評(píng)估非常重要。B超作為一種簡便、無創(chuàng)、經(jīng)濟(jì)的術(shù)前檢查具有其獨(dú)特的優(yōu)勢(shì),但B超診斷乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移具有較高的假陰性率和較低的陰性預(yù)測(cè)值,故本文旨在探討B(tài)超對(duì)其診斷的假陰性率及陰性預(yù)測(cè)值的影響因素。方法本文統(tǒng)計(jì)了2013年1月至2014年12月共308例于浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院行手術(shù)治療的乳腺癌患者。以術(shù)后病理作為金標(biāo)準(zhǔn),并根據(jù)患者不同基本信息、免疫組化結(jié)果及B超結(jié)果分組,分別計(jì)算其假陰性率與陰性預(yù)測(cè)值,用卡方檢驗(yàn)行單因素分析,找出其中有統(tǒng)計(jì)學(xué)意義的影響因素。對(duì)有統(tǒng)計(jì)學(xué)意義的因素進(jìn)行Logistic多因素分析,找出獨(dú)立影響因素。同時(shí)對(duì)連續(xù)性變量行非方差齊性t檢驗(yàn)。結(jié)果Her-2 (p=0.006)、ER (p=0.049)為假陰性率的影響因素,Her-2陽性、ER陰性分別會(huì)降低假陰性率。而多因素分析顯示只有Her-2 (p=0.034)為假陰性率的獨(dú)立影響因素。腫瘤大小(p=0.000),Ki-67值(p=0.038)為陰性預(yù)測(cè)值的影響因素,腫瘤大小減小、Ki-67值減小會(huì)增加其陰性預(yù)測(cè)值。而多因素分析顯示只有腫瘤大小(p=0.000)為陰性預(yù)測(cè)值的獨(dú)立影響因素。結(jié)論Her-2陽性會(huì)降低術(shù)前：B超預(yù)測(cè)乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的假陰性率；而腫瘤大小T≤2cm會(huì)增加其陰性預(yù)測(cè)值。因此,在臨床上B超結(jié)合術(shù)前乳腺腫塊穿刺病理及腫瘤大小對(duì)術(shù)前腋窩淋巴結(jié)轉(zhuǎn)移的預(yù)測(cè)可能具有重要意義。
[Abstract]:The background of axillary lymph node metastasis in breast cancer is an important factor affecting the breast cancer treatment options and prognosis, so the preoperative evaluation is very important. Ultrasound is a simple, non-invasive, economical preoperative examination has its unique advantages, but the ultrasound diagnosis of breast cancer with axillary lymph node negative transfer has a high false negative rate and low predictive value, so this paper aims to explore the influence factors of ultrasound on the false negative rate and negative predictive value of the diagnosis. Methods based on the statistics from January 2013 to December 2014 a total of 308 cases of breast cancer patients underwent surgery in the Second Affiliated Hospital of Zhejiang University School of medicine. The postoperative pathology as the gold standard, and according to the patient different basic information, the results of immunohistochemistry and ultrasound results of grouping, calculate its false negative rate and negative predictive value, univariate analysis using chi square test, find out the significant influence for . multivariate Logistic analysis of statistically significant factors, find out the independent factors. At the same time of the continuous variables for the non homogeneity of variance t test. The results of Her-2 (p=0.006), ER (p=0.049) for the influence factors, the false negative rate of Her-2 positive and ER negative respectively will reduce the false negative rate and more. Factor analysis showed that only Her-2 (p=0.034) as independent factors affecting the false negative rate. Tumor size (p=0.000), Ki-67 (p=0.038) forecast the influence of negative factors, the tumor size decreased, Ki-67 value decreases will increase its negative predictive value. The multivariate analysis showed that only tumor size (p=0.000) independent predictor effect of value was negative. Conclusion positive Her-2 will reduce the preoperative B-mode ultrasound in the prediction of false negative breast cancer axillary lymph node metastasis rate and tumor size less than 2cm; T will increase its negative predictive value. Therefore, in clinical B combined with preoperative breast masses The pathology of the puncture and the size of the tumor may be of great significance for the prediction of axillary lymph node metastasis before operation.

【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R737.9

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本文編號(hào)：1399462