乳腺癌患者腋窝淋巴结转移的危险因素及行X线摄影与CT检查的诊断效能分析

doi:10.3969/j.issn.1006-6233.2024.03.028

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摘要 目的:探讨乳腺癌患者腋窝淋巴结转移的危险因素及X线与CT检查的诊断效能比较。方法:选取2021年1月至2023年5月在我院治疗的乳腺癌患者112例,分析发生和未发生腋窝淋巴结转移患者临床资料差异;同时分析X线、CT检查诊断腋窝淋巴结转移的价值。结果:112例患者中,腋窝淋巴结转移患者32例,腋窝淋巴结转移率为28.57%;发生腋窝淋巴结转移患者组织低分化比例、组织类型为浸润性癌比例、有脉管浸润比例、肿瘤直径≥5cm比例、组织Ki-67表达≥14%比例分别为68.75%、90.63%、28.13%、31.25%和84.38%,明显高于未发生腋窝淋巴结转移患者(P<0.05);Logistic回归分析显示:分化程度、病灶组织类型、脉管浸润、Ki-67表达是乳腺癌患者发生腋窝淋巴结转移的影响因素(P<0.05);X线诊断腋窝淋巴结转移与病理结果一致性Kappa值为0.500,P<0.05,一致性较差;CT诊断腋窝淋巴结转移与病理结果一致性Kappa值为0.825,P<0.05,一致性较好;CT诊断腋窝淋巴结转移的准确性、灵敏性和阴性预测值分别为92.86%、87.50%和95.00%,明显高于X线检查(P<0.05)。结论:乳腺癌患者腋窝淋巴结转移受分化程度、病灶组织类型、脉管浸润、Ki-67表达的影响;相较于X线,CT诊断腋窝淋巴结转移的价值较高。

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	王浩宇
	石文达
	赵晓彬
	崔志新

关键词 ：乳腺癌, 腋窝淋巴结转移, 危险因素, X线, CT检查

Abstract：Objective: To explore the risk factors of axillary lymph node metastasis in breast cancer patients and compare the diagnostic efficacy of X-ray and CT examinations.Methods: A total of 112 breast cancer patients treated in our hospital from January 2021 to May 2023 were selected. Differences in clinical data between patients with and without axillary lymph node metastasis were analyzed. The diagnostic value of X-ray and CT examinations for axillary lymph node metastasis was also assessed. Results: Among the 112 patients, 32 had axillary lymph node metastasis, lymph node metastasis rate was 28.57%. The proportion of patients with axillary lymph node metastasis with low differentiation, invasive cancer, vascular infiltration, tumor diameter ≥5cm, and Ki-67 expression ≥14% were 68.75%, 90.63%, 28.13%, 31.25%, and 84.38%, respectively, which were significantly higher than those without axillary lymph node metastasis (P<0.05). Logistic regression analysis showed that differentiation degree, focus tissue type, vascular invasion, Ki-67 expression were the influencing factors of axillary lymph node metastasis in breast cancer patients (P<0.05). The consistency between X-ray diagnosis of axillary lymph node metastasis and pathological results was poor, with a Kappa value of 0.500 and P<0.05. The consistency between CT diagnosis of axillary lymph node metastasis and pathological results was good, with a Kappa value of 0.825 and P<0.05. The sensitivity, accuracy, and negative predictive values of CT in diagnosing axillary lymph node metastasis were 92.86%, 87.50%, and 95.00%, respectively, which were significantly higher than those of X-ray examination (P<0.05). Conclusion: The occurrence of axillary lymph node metastasis in breast cancer patients is influenced by differentiation degree, lesion tissue type, vascular invasion, and Ki-67 expression. Compared to X-ray, CT demonstrates higher diagnostic value for axillary lymph node metastasis.

Key words： Breast cancer Axillary lymph node metastasis Risk factors X-ray CT examination

基金资助:河北省承德市科技计划自筹经费项目,(编号:202204A068)

通讯作者: 崔志新

引用本文:

王浩宇, 石文达, 赵晓彬, 崔志新. 乳腺癌患者腋窝淋巴结转移的危险因素及行X线摄影与CT检查的诊断效能分析[J]. 河北医学, 2024, 30(3): 506-510.
WANG Haoyu, SHI Wenda, ZHAO Xiaobin, et al. Risk Factors for Axillary Lymph Node Metastasis in Breast Cancer Patients and Comparative Diagnostic Efficacy of X-ray Imaging and CT Scans. HeBei Med, 2024, 30(3): 506-510.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.03.028 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I3/506

[1] Wang YW,Chen X,Tian Y,et al.Decreased expression of circ_0000160 in breast cancer with axillary lymph node metastasis[J].Front Mol Biosci,2022,8(8):e690826.
[2] Luo J,Chen S,Chen J,et al.Identification and validation of DNA methylation markers to predict axillary lymph node metastasis of breast cancer[J].PLoS One,2022,17(12):e0278270.
[3] Marino MA,Avendano D,Zapata P,et al.Lymph node imaging in patients with primary breast cancer:concurrent dagnostic tools[J].Oncologist,2020,25(2):e231-e242.
[4] Chung HL,Le-Petross HT,Leung JWT.Imaging updates to breast cancer lymph node management[J].Radiographics,2021,41(5):1283-1299.
[5] Wang W,Qiu P,Li J.Internal mammary lymph node metastasis in breast cancer patients based on anatomical imaging and functional imaging[J].Breast Cancer,2022,29(6):933-944.
[6] Zhao R,Jiang H,Cao J,et al.Prediction of axillary lymph node metastasis in invasive breast cancer by sound touch elastography[J].Ultrasound Med Biol,2022,48(9):1879-1887.
[7] Huang Z,Wu Z,Zou QQ,et al.Risk factors of non-sentinel lymph node metastasis in breast cancer with 1-2 sentinel lymph node macrometastases underwent total mastectomy:a case-control study[J].World Surg Oncol,2023,21(1):125.
[8] 颜美莹,阮磊,杨琛,等.乳腺鳞状细胞癌的多模态影像学特征及其与腋窝淋巴结转移相关性[J].肿瘤学杂志,2022,28(5):364-369.
[9] 孙献甫,张强,牛连杰,等.早期乳腺癌患者术前腋窝淋巴结负荷预测模型的构建[J].中华肿瘤杂志,2021,43(5):563-568.
[10] 赵欣,苏丹柯.影像学术前诊断乳腺癌腋窝转移性淋巴结的研究进展[J].中国癌症防治杂志,2022,14(4):475-479.
[11] 张玉姣,宋德领,王燕飞,等.基于乳腺X线图像影像组学列线图对乳腺癌腋窝淋巴结转移的预测价值[J].放射学实践,2022,37(1):48-54.
[12] 刘正敏,易照雄,陈颖柏,等.CT,超声弹性成像在鉴别乳腺癌腋窝淋巴结性质中的临床应用价值分析[J].中国CT和MRI杂志,2022,20(12):93-94.
[13] Fu Y,Jiang J,Chen S,et al.Establishment of risk prediction nomogram for ipsilateral axillary lymph node metastasis in T1 breast cancer[J].Zhejiang Da Xue Xue Bao Yi Xue Ban,2021,50(1):81-89.
[14] Cai SL,Wei RM,Han L,et al.Risk factors of non-sentinel lymph node metastasis in 443 breast cancer patients with sentinel lymph node-positive[J].Medicine (Baltimore),2022,101(29):e29286.
[15] Zhang W,Xu J,Wang K,et al.Independent risk factors for axillary lymph node metastasis in breast cancer patients with one or two positive sentinel lymph nodes[J].BMC Womens Health,2020,20(1):143-145.