声触诊组织量化成像技术对乳腺癌前哨淋巴结的鉴别诊断价值
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摘要
[目的]探讨声触诊组织量化成像(VTIQ)技术在乳腺癌前哨淋巴结(SLN)转移中的检出效能。[方法]回顾性分析2017年1月至2017年9月在哈尔滨医科大学附属肿瘤医院就诊的经病理证实的52例乳腺癌患者前哨淋巴结的图像资料。记录淋巴结的长轴及短轴长度、淋巴结最大皮质厚度、淋巴结长短径之比二维超声声像图特征及VTIQ测量的剪切波横向速度(SWV)平均值。[结果]对52例患者的55枚淋巴结进行了检测,术后病理显示前哨淋巴结53枚(除外2例非前哨淋巴结),其中转移性淋巴结19枚(35.8%),反应性增生淋巴结34枚(64.2%)。淋巴结的长轴及短轴长度、淋巴结长短径之比诊断SLN是否转移无统计学意义(P>0.05);淋巴结最大皮质厚度(良性与转移3.24±1.34mm与5.95±3.35mm)和SWV平均值(2.10±0.35mm与2.55±0.55m/s)诊断SLN是否转移有统计学意义(P<0.05)。淋巴结最大皮质厚度、SWV平均值及两者联合的ROC曲线,诊断前哨淋巴结转移的ROC曲线下面积分别为0.811、0.749和0.830;诊断转移的准确率分别为83.0%、69.8%和84.9%;敏感度分别为63.2%、68.4%和63.2%;特异性分别为94.1%、70.6%和97.1%;阳性预测值分别为85.7%、56.5%和92.3%;阴性预测值分别为82.1%、80.0%和82.5%。[结论] VTIQ技术对乳腺癌前哨淋巴结转移性癌有一定的诊断价值,结合常规超声应用可提高对前哨淋巴结转移的诊断效能。
[Purpose] To explore the diagnostic value of virtual touch imaging quantification(VTIQ)for sentinel lymph node(SLN) metastasis of breast cancer. [Methods] The image data of sentinel lymph nodes in 52 breast cancer patients confirmed by pathology in Harbin Medical University Cancer Hospital from January 2017 to September 2017 were retrospectively analyzed. The length of the long axis and the short axis of the lymph nodes,the maximum thickness of the lymph node and the mean value of the shear wave velocity(SWV) measured by VTIQ were recorded. [Results]A total of 55 SLNs lymph nodes obtained from the 52 patients were evaluated. The post operation pathology showed 53 sentinel lymph nodes(except for 2 cases of non sentinel lymph nodes),19 of them(35.8%) were metastatic,and 34(64.2%) were benign. There was no significant difference in the diagnosis of SLN metastasis between the long axis,short axis length of lymph nodes and the length to diameter ratio of lymph nodes(P>0.05). The maximum cortical thickness(benign versus metastatic,3.24±1.34 mm versus 5.95±3.35 mm) and the mean value of SWV(2.10±0.35 m/s versus2.55±0.55 m/s) were statistically in metastatic lymph nodes(P<0.05). The ROC curve of maximum cortical thickness,the SWV mean value and the two combined were drawn respectively. The areas under the ROC curve of the three were 0.811,0.749,and 0.830,respectively. The following accuracy was 83%,69.8% and 84.9%,and the sensitivity was 63.2%,68.4% and 63.2%,respectively,while the specificity was 94.1%,70.6% and 97.1%,respectively 85.7%,56.5% and 92.3% was in positive predictive values 82.1%,80% and 82.5% was in negative predictive values. [Conclusions] VTIQ has a certain diagnostic value for the evaluation of the status of sentinel lymph nodes,combined two-dimensional ultrasound can improve the diagnostic efficiency of sentinel lymph node metastasis.
[Purpose] To explore the diagnostic value of virtual touch imaging quantification(VTIQ)for sentinel lymph node(SLN) metastasis of breast cancer. [Methods] The image data of sentinel lymph nodes in 52 breast cancer patients confirmed by pathology in Harbin Medical University Cancer Hospital from January 2017 to September 2017 were retrospectively analyzed. The length of the long axis and the short axis of the lymph nodes,the maximum thickness of the lymph node and the mean value of the shear wave velocity(SWV) measured by VTIQ were recorded. [Results]A total of 55 SLNs lymph nodes obtained from the 52 patients were evaluated. The post operation pathology showed 53 sentinel lymph nodes(except for 2 cases of non sentinel lymph nodes),19 of them(35.8%) were metastatic,and 34(64.2%) were benign. There was no significant difference in the diagnosis of SLN metastasis between the long axis,short axis length of lymph nodes and the length to diameter ratio of lymph nodes(P>0.05). The maximum cortical thickness(benign versus metastatic,3.24±1.34 mm versus 5.95±3.35 mm) and the mean value of SWV(2.10±0.35 m/s versus2.55±0.55 m/s) were statistically in metastatic lymph nodes(P<0.05). The ROC curve of maximum cortical thickness,the SWV mean value and the two combined were drawn respectively. The areas under the ROC curve of the three were 0.811,0.749,and 0.830,respectively. The following accuracy was 83%,69.8% and 84.9%,and the sensitivity was 63.2%,68.4% and 63.2%,respectively,while the specificity was 94.1%,70.6% and 97.1%,respectively 85.7%,56.5% and 92.3% was in positive predictive values 82.1%,80% and 82.5% was in negative predictive values. [Conclusions] VTIQ has a certain diagnostic value for the evaluation of the status of sentinel lymph nodes,combined two-dimensional ultrasound can improve the diagnostic efficiency of sentinel lymph node metastasis.
引文
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[7]Shin JH,Choi HY,Moon BI,Sung SH.In vitro sonographic evaluation of sentinel lymph nodes for detecting metastasis in breast cancer:comparison with histopathologic results[J].J Ultrasound Med,2004,23(7):923-928.
[8]Cheng KL,Choi YJ,Shim WH,et al.virtual touch tissue imaging quantification shear wave elastography:prospective assessment of cervical lymph nodes[J].Ultrasound in Medicine&Biology,2016,42(2):378-386.
[9]Zhang JP,Liu HY,Ning CP,et al.Quantitative analysis of enlarged cervical lymph nodes with ultrasound elastography[J].Asian Pacific Journal of Cancer Prevention Apjcp,2015,16(16):7291-7294.
[2]Zhang JP,Liu HY,Ning CP,et al.Quantitative analysis of enlarged cervical lymph nodes with ultrasound elastography[J].Asian Pacific Journal of Cancer Prevention Apjcp,2015,16(16):7291-7294.
[3]Zhou LJ,Jiang TA,Zhu WJ,et al.Full quantitative virtual touch tissue imaging SWV value in the detection of lymph node metastasis using in papillary thyroid cancer neck[J].Chinese Ultrasound MED,2017,33(9):769-772.[周利杰,蒋天安,朱文军,等.定量声触诊组织成像技术的SWV值在甲状腺乳头状癌颈部转移淋巴结检出中的应用[J].中国超声医学杂志,2017,33(9):769-772.]
[4]Bailey A,Layne G,Shahan C,et al.Comparison between ultrasound and pathologic status of axillary lymph nodes in clinically node-negative breast cancer patients[J].Am Surg,2015,81(9):865-869.
[5]Zhang CZ,Wang F,Hong H,et al.The value of ultrasound in the diagnosis of superficial lymphnode disease[J].Inner Mongolia Medical Journal,2017,49(4):420-422.[张春征,王芳,红华,等.超声对浅表淋巴结疾病的诊断价值[J].内蒙古医学杂志,2017,49(4):420-422.]
[6]Gu YS,Li YJ,Wen G,et al.Application of ultrasound elastography in judging the axillary lymph node[J].Chinese Journal of Ultrasound Medicine,2013,29(10):886-889.[谷英士,李颖嘉,文戈,等.超声弹性成像在判断腋窝淋巴结性质中的应用[J].中国超声医学杂志,2013,29(10):886-889.]
[7]Shin JH,Choi HY,Moon BI,Sung SH.In vitro sonographic evaluation of sentinel lymph nodes for detecting metastasis in breast cancer:comparison with histopathologic results[J].J Ultrasound Med,2004,23(7):923-928.
[8]Cheng KL,Choi YJ,Shim WH,et al.virtual touch tissue imaging quantification shear wave elastography:prospective assessment of cervical lymph nodes[J].Ultrasound in Medicine&Biology,2016,42(2):378-386.
[9]Zhang JP,Liu HY,Ning CP,et al.Quantitative analysis of enlarged cervical lymph nodes with ultrasound elastography[J].Asian Pacific Journal of Cancer Prevention Apjcp,2015,16(16):7291-7294.