摘要: |
目的 分析超声联合钼靶检查对T≤2cm早期浸润性乳腺癌患者豁免前哨淋巴结活检(sentinel lymph node biopsy,SLNB)的价值。 方法 选取重庆医科大学附属第一医院2018-01~2019-06肿瘤直径T≤2cm且术中行SLNB的122例早期浸润性乳腺癌患者,对其患者资料进行回顾性研究,收集超声、钼靶、核磁共振(MRI)及SLNB的结果,分别与术后腋窝淋巴结活检结果进行比较。 结果 122例T≤2cm早期浸润性乳腺癌患者中,29例患者术后腋窝淋巴结活检结果为阳性。SLNB、超声、MRI及钼靶与金标准一致性比较, Kappa值分别为0.721,0.668,0.620,0.422,差异具有统计学意义(p<0.05);超声、钼靶、MRI两两并联诊断或三者并联诊断中,超声并联钼靶同金标准一致性最高(Kappa=0.702,p<0.05)。结论 在诊断腋窝淋巴结状态上,超声并联钼靶与金标准一致性较高,虽存在一定假阴性率,但本研究对T≤2cm早期浸润性乳腺癌患者豁免SLNB提供了有力的证据支撑。 |
关键词: 早期浸润性乳腺癌 前哨淋巴结活检 超声 钼靶 腋窝淋巴结转移 |
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Analysis of the value of ultrasound combined with molybdenum target to avoid sentinel lymph node biopsy for early invasive breast cancer |
chenhuan
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Department of Endocrinology and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University
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Abstract: |
Objective To analyze the value of ultrasound combined with mammography target in patients with early invasive breast cancer with T ≤ 2cm to avoid SLNB. Methods A retrospective study was conducted on 122 early invasive breast cancer patients with tumor diameter T ≤ 2 cm and SLNB completed during operation in the first affiliated Hospital of Chongqing Medical University from January 2018 to June 2019. The results of ultrasound, molybdenum target, MRI and SLNB were collected and compared with the results of postoperative axillary lymph node biopsy. Results Of the 122patients with early invasive breast cancer with T ≤ 2cm, 29 patients showed positive results of axillary lymph node biopsy after operation. Compared with the gold standard, the Kappa values of SLNB, ultrasound, MRI and molybdenum target were 0.721, 0.668, 0.620 and 0.422 respectively, and the difference was statistically significant (p < 0.05).For two or three parallel diagnoses of ultrasound, molybdenum target and MRI, ultrasonic parallel molybdenum targets were superior to other parallel diagnostic methods in terms of gold standard consistency(Kappa=0.702,p<0.05). Conclusion In the diagnosis of axillary lymph node metastasis, the ultrasonic parallel molybdenum target is highly consistent with the gold standard. Although there is a certain false negative rate, this study provides strong evidence for patients with early invasive breast cancer with T ≤ 2cm to avoid SLNB. |
Key words: Early invasive breast cancer Sentinel lymph node biopsy Ultrasound Molybdenum target Axillary lymph node metastasis |