[1]杜 慧,刘 昕.常规超声联合超声造影对非特殊型浸润性乳腺癌腋窝淋巴结转移的预测价值[J].医学信息,2024,37(01):120-124,149.[doi:10.3969/j.issn.1006-1959.2024.01.020]
　DU Hui,LIU Xin.Predictive Value of Conventional Ultrasound Combined with Contrast-enhanced Ultrasound in Axillary Lymph Node Metastasis for Invasive Breast Carcinoma of No Specific Type[J].Journal of Medical Information,2024,37(01):120-124,149.[doi:10.3969/j.issn.1006-1959.2024.01.020]
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常规超声联合超声造影对非特殊型浸润性乳腺癌腋窝淋巴结转移的预测价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年01期
页码:
120-124,149
栏目:
论著
出版日期:
2024-01-01

文章信息/Info

Title:
Predictive Value of Conventional Ultrasound Combined with Contrast-enhanced Ultrasound in Axillary Lymph Node Metastasis for Invasive Breast Carcinoma of No Specific Type
文章编号:
1006-1959（2024）01-0120-06
作者:
杜 慧; 刘 昕
（1.承德医学院研究生学院，河北 承德 067000；2.保定市第一中心医院超声科，河北 保定 071000）
Author(s):
DU Hui; LIU Xin
(1.Graduate School of Chengde Medical College,Chengde 067000,Hebei,China;2.Department of Ultrasound,the First Central Hospital of Baoding City,Baoding 071000,Hebei,China)
关键词:
常规超声; 超声造影; 非特殊型浸润性乳腺癌; 腋窝淋巴结转移
Keywords:
Conventional ultrasound; Contrast-enhanced ultrasound; Invasive breast carcinoma of no specific type; Axillary lymph node metastasis
分类号:
R737.9
DOI:
10.3969/j.issn.1006-1959.2024.01.020
文献标志码:
A
摘要:
目的 分析非特殊型浸润性乳腺癌（IBC-NST）病灶双模态超声征象对腋窝淋巴结转移的预测价值。方法 回顾性收集2021年11月-2023年1月就诊于保定市第一中心医院的IBC-NST患者原发病灶的常规超声（US）、超声造影（CEUS）征象资料252例，根据腋窝淋巴结清扫术后病理结果分为转移组（n=148）和非转移组（n=104）。通过单因素及多因素分析建立单模态及双模态超声Logistic回归预测模型，并绘制受试者工作特征（ROC）曲线，评估3种预测模型对腋窝淋巴结转移的预测效能。结果 转移组与非转移组间的病灶大小、微钙化、Adler血流分级、位置、增强后边缘放射状汇聚、增强后病灶范围变化、穿支血管和灌注缺损的比较，差异有统计学意义（P＜0.05）。多因素分析结果显示：US与CEUS联合诊断时，得出Logistic回归预测模型Logit（P）=-3.870+1.875Adler血流分级+1.112灌注缺损+1.667穿支血管+1.820增强后病灶范围变化，其预测腋窝淋巴结转移的ROC曲线下面积（AUC）（0.874）与US（0.689）、CEUS（0.827）比较，差异有统计学意义（Z=5.844，P＜0.05；Z=2.887，P=0.004）。双模态超声预测模型的灵敏度、特异度、准确度、PPV和NPV均高于US、CEUS单模态超声预测模型，预测效能最佳。结论 US、CEUS联合的双模态超声预测模型对IBC-NST早期腋窝淋巴结转移有较高的预测价值，可为临床预后的评估提供可靠的影像学依据。
Abstract:
Objective To analyze the predictive value of dual-modality ultrasound signs of invasive breast carcinoma of no specific type (IBC-NST) lesions on axillary lymph node metastasis.Methods The data of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) signs of primary lesions in 252 patients with IBC-NST who were admitted to the First Central Hospital of Baoding from November 2021 to January 2023 were retrospectively collected. According to the pathological results after axillary lymph node dissection, they were divided into metastasis group (n=148) and non-metastasis group (n=104). The single-modality and dual-modality ultrasound Logistic regression prediction models were established by univariate and multivariate analysis, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive efficacy of the three prediction models for axillary lymph node metastasis.Results There were significant differences in lesion size, microcalcification, Adler blood flow grading, location, radial convergence of the edge after enhancement, change of lesion range after enhancement, perforator vessels and perfusion defects between the metastatic group and the non-metastatic group (P<0.05). The results of multivariate analysis showed that when US and CEUS were jointly diagnosed, the Logistic regression prediction model Logit (P)=-3.870+1.875 Adler blood flow grade+1.112 perfusion defect+1.667 perforator vessel+1.820 changes in lesion range after enhancement, which predicted the area under the curve (AUC) (0.874) of axillary lymph node metastasis compared with US (0.689) and CEUS (0.827), the difference was statistically significant (Z=5.844, P<0.05; Z=2.887, P=0.004). Moreover, the sensitivity, specificity, accuracy, PPV and NPV of the dual-modality ultrasound prediction model were higher than those of the US and CEUS single-modality ultrasound prediction models, and the prediction efficiency was the best.Conclusion The dual-modality ultrasound prediction model combined with US and CEUS has high predictive value for early axillary lymph node metastasis in IBC-NST, and can provide reliable imaging basis for clinical prognosis evaluation.

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更新日期/Last Update: 1900-01-01