乳腺癌超声征象与淋巴结转移关系的单因素及多因素分析

目的 探讨乳腺癌原发肿块、腋窝淋巴结超声征象与淋巴结转移的关系.方法 回顾性分析146例乳腺癌患者151个原发肿块(66个伴淋巴结转移,85个未转移)及腋窝淋巴结声像图特征,与病理结果对照,用单因素(X~2检验)和多因素(Logistic回归)分析各声像图特征与淋巴结转移的关系,对超声征象和病理的吻合度进行k系数检验.对乳腺癌中提示淋巴结转移的超声征象与有转移的腋窝淋巴结征象进行相关分析.结果 单因素和多因素分析显示肿块最大直径、血流分级及淋巴结最大皮质厚度与淋巴结转移关系密切(X~2=37.939、13.153、69.128,OR=6.632、3.714、35.442,P均<0.01),且与病理结果有较好的吻合度(k=0.501、0.690、0.673),能较准确地判断腋窝淋巴结转移.肿块最大直径、血流分级与淋巴结最大皮质厚度有较好相关性(X2=40.132、33.128,P均<0.01).肿块距体表距离以及间质纤维结构改变等征象对判断乳腺癌淋巴结转移有一定提示作用.结论 采用单因素及多因素分析乳腺癌超声征象能为术前准确判断腋窝淋巴结转移提供重要的依据.

Correlation between ultrasonographic signs and axillary lymph node metastasis in breast cancer by univariate and multivariate analysis

Objective To explore the correlation between ultrasonographic signs of breast cancer and axillary lymph node metastasis.Methods The sonographic features of 146 patients with 151 breast malignant noplasms(66 with metastasis,85 without metastssis)and axillary lymph nodes were retrospectively analyzed.The results of ultrasonography were compared with pathology.The relationship between these signs and axillary lymph node metastasis were evalued by univariate(Chi-square test)and multivariate analysis(Logistic regression).Agreement was measured with k statistics between ultrasonographic signs and pathology.The correlation between sonographic criteria and axillary lymph node metastasis were evalued.Results The primary tumor size,grade of tumor flow and maximum cortex thickness correlated well with axillary lymph node metastasis by univariate and multivariate analysis(X~2=37.939,13.153,69.128;OR=6.632,3.714,35.442,respectively,P<0.01).Agreement was moderate(k=0.501,0.690,0.673).The primary tumor size,grade of tumor flow and maximum cortex thickness could predict metastatis accurately.The primary tumor size,grade of tumor flow correlated well with maximum cortex thickness(X~2=40.132,33.128,P<0.01).The distance from tumor to skin,changes of fibred structures and some other features could predict metastatis.Conclusions Evaluation of ultrasonographic signs by univariate and multivariate analysis is useful in predicting of breast cancer metastasis to axillary lymph nodes before operation.