超声在乳腺癌患者腋窝淋巴结转移相关因素分析中的作用

目的探讨超声诊断乳腺癌患者腋窝淋巴结转移的较佳诊断指标。方法选取66例乳腺癌住院患者,详细记录患者年龄、原发灶部位、大小、原发灶纵横比(L/T)、边界、内部钙化灶、后方回声,血流分级、血流速度及阻力指数,然后探测同侧腋窝淋巴结,记录淋巴结最大径、淋巴结L/T、皮质最大厚径和血流分布类型,应用χ2检验和Logistic回归进行统计学分析。结果患者原发灶的位置、原发灶最大径、原发灶血流丰富程度、淋巴结局部皮质最厚径、淋巴结L/T、淋巴结血流分布类型与腋窝淋巴结转移相关(P0.05),相关程度由高到低依次为:淋巴结局部皮质最厚径、淋巴结血流分布类型、原发灶血流丰富程度、原发灶最大径、原发灶的位置及淋巴结L/T。结论综合多项因素判别乳腺癌患者腋窝淋巴结的良恶性,将有助于提高超声诊断腋窝淋巴结转移的准确率,更为准确地判断腋腋窝淋巴结的状态。

Value of ultrasound in related factors analysis of axillary lymph nodes metastasis in breast cancer

Objective To explore the better ultrasonic diagnostic indicators for breast cancer patients with axillary lymph node metastasis （LNM）. Methods Sixty-six hospitalized breast cancer patients were enrolled. The patients＇ age, breast primary tumor site, size, L/T value, the border, the internal calcified lesions, rear echo, blood flow grades, blood flow velocity and resistance index were recorded. And then the ipsilateral axillary LNs were carefully detected, the diameter of the LNs, L/T value, the local cortical thickness and the type of blood flow distribution were recorded. The chi-square test and Logistic regression statistical analysis were applied. Results The primary tumor site,maximal diameter of the primary tumor, primary tumor blood flow richness, the thickest local cortex diameter, lymph node L/T value and the type of lymph node blood flow distribution were related to axillary LNM（P〈0.05 ）. The degree of correlation between the relevant indicators and axillary LNM was as follows： lymph node diameter of local cortical thickness 〉the type of lymph flow distribution 〉the primary tumor blood flow richness〉primary tumor diameter〉the primary tumor site〉lymph node I/r. Conclusion Discrimination of benign and malignant LNs in breast cancer patients with multiple factors can help to improve the accuracy rate of ultrasound in diagnosis of LNM and to determine the status of axillary LNs more accurately.