多参数超声联合穿刺诊断三阴性乳腺癌腋窝淋巴结转移

doi:10.12117/jccmi.2020.05.005

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Abstract Objective: To explore the value of conventional ultrasound combined with shear wave elastography(SWE) and ultrasound-guided fine needle aspiration(FNA) cytology in preoperative evaluation of axillary lymph node metastasis in triple-negative breast cancer(TNBC). Methods: Female patients pathologically confirmed to be TNBC in the Guizhou Medical University Affiliated Hospital were recruited as subjects. There were 48 cases in the metastatic group and 57 cases in the reaction group. The detected lymph nodes were subjected to conventional ultrasound and SWE examination, and the ultrasound and SWE multi-parameter indicators of the metastatic group and the reaction group were compared. Ultrasound-guided FNA cytology was performed on suspected axillary lymph nodes to evaluate the diagnostic efficacy of conventional ultrasound, SWE, FNA, and the combination of the three in TNBC axillary lymph nodes. Results: The proportion of patients with metastatic lymph nodes in long to short dimension ratio(L/S)≤2, irregular morphology, missing lymphatic portal, and no lymphatic portal blood flow distribution was higher than that of the reaction group. The mean young’s module(YM) was higher than that of the reaction group, and the difference was statistically significant(both P<0.05). The sensitivity of SWE(87.50%) for the diagnosis of TNBC metastatic axillary lymph nodes was higher than that of conventional ultrasound(79.17%) and FNA(75.00%). The specificity of FNA(94.74%) for the diagnosis of TNBC metastatic axillary lymph nodes was higher than that of SWE(82.46%) and conventional ultrasound(70.18%). The combined fitting equation of conventional ultrasound, SWE and FNA was Logit(P)=-5.301 +5.860×positive FNA+2.259×L/S≤2+1.326×irregular morphology+4.081×missing lymphatic portal+2.729×no lymphatic portal blood flow+0.121×YM average. The sensitivity of the combination was 97.92%, which was higher than that of conventional ultrasound, SWE and FNA respectively. The specificity was 87.72%, which was slightly lower than FNA, but significantly higher than conventional ultrasound and SWE. Conclusion: Conventional ultrasound combined with elastography and ultrasound-guided FNA could improve the accuracy in diagnosis of metastatic axillary lymph node of TNBC.

Key words： Breast neoplasms Lymphatic metastasis Ultrasonography, Doppler, color Biopsy, fine-needle

Received: 14 October 2019

PACS:	Ｒ737.9
	Ｒ445.1

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	Articles by authors
	HU Xiao-li
	LIAO Chun-yan
	WU Da-lang
	LIU Chan
	CHEN Xia

Cite this article:

HU Xiao-li,LIAO Chun-yan,WU Da-lang, et al. Diagnosis of axillary lymph node metastasis in triple-negative breast cancer by multi-parameter ultrasound combined with biopsy[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(5): 325-329.

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http://www.jccmi.com.cn/EN/10.12117/jccmi.2020.05.005 OR http://www.jccmi.com.cn/EN/Y2020/V31/I5/325

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