乳腺浸润性导管癌高频超声不同参数弹性成像的特征分析及对淋巴结转移的诊断

doi:10.3969/j.issn.1006-6233.2024.07.017

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摘要 目的: 观察乳腺浸润性导管癌高频超声、不同参数弹性成像的特征,并分析其对淋巴结转移的诊断价值。方法: 回顾性选取2021年1月至2023年1月于本院就诊且经病理学检查证实的96例乳腺浸润性导管癌患者,依据淋巴结转移情况将患者分为转移组与未转移组,所有患者入院时均接受高频超声与超声弹性成像检查,对比不同淋巴结转移情况的患者高频超声及超声弹性成像参数,采用Logistic回归分析其与乳腺浸润性导管癌患者淋巴结转移的关系,绘制ROC探讨高频超声、超声弹性成像参数对淋巴结转移的诊断价值。结果: 96例乳腺浸润性导管癌患者中淋巴结转移59例(61.46%),未转移37例(38.54%);淋巴结转移组腋窝淋巴结皮质厚度、腋窝淋巴结纵径、纵横径比值大于未转移组,周边型或混合型血流模式占比、淋巴门消失占比高于未转移组(P<0.05);转移组最大弹性模量值、弹性数据离散度值、病灶与周边组织比值大于未转移组(P<0.05);经Logistic回归分析,结果显示,腋窝淋巴结皮质厚度大、腋窝淋巴结纵径大、纵横径比值大、周边型或混合型血流模式、淋巴门消失、最大弹性模量值大、弹性数据离散度值大、病灶与周边组织比值大是乳腺浸润性导管癌患者淋巴结转移的危险因素(OR>1,P<0.05);绘制ROC曲线,结果显示,腋窝淋巴结皮质厚度、腋窝淋巴结纵径、纵横径比值、血流模式、淋巴门消失、最大弹性模量值、弹性数据离散度值、病灶与周边组织比值对乳腺浸润性导管癌患者淋巴结转移具有一定预测价值(AUC=0.833、0.782、0.758、0.721、0.646、0.714、0.685、0.730),联合诊断价值更高(AUC=0.908)。结论: 乳腺浸润性导管癌患者高频超声、超声弹性成像特征与淋巴结转移密切相关,可用于淋巴结转移的术前诊断。

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关键词 ：乳腺浸润性导管癌, 高频超声, 弹性成像, 淋巴结转移

Abstract：Objective: To investigate the characteristics of high-frequency ultrasound and different parameter elasticity imaging of invasive ductal breast cancer, and to analyze its diagnostic value for lymph node metastasis. Methods: A retrospective study was conducted on 96 patients with invasive ductal breast cancer who were diagnosed by pathology and treated in our hospital from January 2021 to January 2023. According to the lymph node metastasis, the patients were divided into metastasis group and non-metastasis group. All patients underwent high-frequency ultrasound and ultrasound elastography examination upon admission. The high-frequency ultrasound and ultrasound elastography parameters of patients with different lymph node metastasis were compared. Logistic regression analysis was used to analyze the relationship between these parameters and lymph node metastasis in patients with invasive ductal breast cancer. ROC curves were drawn to explore the diagnostic value of high-frequency ultrasound and ultrasound elastography parameters for lymph node metastasis. Results: Among the 96 patients with invasive ductal breast cancer, 59 cases (61.46%) had lymph node metastasis and 37 cases (38.54%) had no lymph node metastasis. The cortical thickness of axillary lymph nodes, the longitudinal diameter of axillary lymph nodes, and the longitudinal-to-transverse diameter ratio in the metastasis group were greater than those in the non-metastasis group. The proportion of peripheral or mixed blood flow patterns and the proportion of lymph node disappearance were higher in the metastasis group than in the non-metastasis group (P<0.05). The maximum elasticity modulus value, elasticity data dispersion value, and the ratio of lesion to surrounding tissue in the metastasis group were greater than those in the non-metastasis group (P<0.05). Logistic regression analysis showed that the risk factors for lymph node metastasis in patients with invasive ductal breast cancer were large axillary lymph node cortical thickness, large axillary lymph node longitudinal diameter, large longitudinal-to-transverse diameter ratio, peripheral or mixed blood flow pattern, lymph node disappearance, large maximum elasticity modulus value, large elasticity data dispersion value, and large ratio of lesion to surrounding tissue (OR>1, P<0.05). ROC curve analysis showed that axillary lymph node cortical thickness, axillary lymph node longitudinal diameter, longitudinal-to-transverse diameter ratio, blood flow pattern, lymph node disappearance, maximum elasticity modulus value, elasticity data dispersion value, and the ratio of lesion to surrounding tissue had a certain predictive value for lymph node metastasis in patients with invasive ductal breast cancer (AUC=0.833, 0.782, 0.758, 0.721, 0.646, 0.714, 0.685, 0.730), and the combined diagnostic value was higher (AUC=0.908). Conclusion: The characteristics of high-frequency ultrasound and ultrasound elastography in patients with invasive ductal breast cancer are closely related to lymph node metastasis and can be used for preoperative diagnosis of lymph node metastasis.

Key words： Invasive ductal breast cancer High-frequency ultrasound Elasticity imaging Lymph node metastasis

基金资助:广东省医学科学技术研究基金项目,(编号:A201810111)

通讯作者: 潘志远

引用本文:

元敏, 姚晓军, 谢淑慧, 刘峰, 唐子峰, 潘志远. 乳腺浸润性导管癌高频超声不同参数弹性成像的特征分析及对淋巴结转移的诊断[J]. 河北医学, 2024, 30(7): 1150-1156.
YUAN Min, YAO Xiaojun, XIE Shuhui, et al. Characterization Analysis of High-Frequency Ultrasound and Different Parameter Elasticity Imaging of Invasive Ductal Breast Cancer and Its Diagnosis of Lymph Node Metastasis. HeBei Med, 2024, 30(7): 1150-1156.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.07.017 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I7/1150

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