乳腺癌肿块超声声像图特征与腋窝淋巴结转移的关系
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摘要
目的探讨乳腺癌肿块超声声像图特征与腋窝淋巴结转移的关系。方法回顾性分析2014年6月至2016年8月收集的84例乳腺癌肿块的二维超声声像图特征(肿块大小、形态、边缘、钙化、血流信号等)以及腋窝淋巴结转移情况,判断两者之间的关系。结果超声检查结果显示,84例乳腺癌肿块中,出现腋窝淋巴结转移者共50例,无腋窝淋巴结转移者34例。与乳腺癌无腋窝淋巴结转移者相比,腋窝淋巴结转移患者在肿块边缘有无毛刺征、肿块内部血供情况两方面比较差异均有统计学意义(P<0.05,P<0.01)。腋窝淋巴结转移者在乳腺癌肿边缘有毛刺特征、癌肿内部血供丰富时容易发生转移。结论乳腺癌腋窝淋巴结转移在乳腺肿块边缘、肿块内部血供情况方面有典型的二维超声声像表现,有助于判断其淋巴结转移的情况。
Objective To investigate the correlation between ultrasonographic features of breast cancer masses and axillary lymph node metastasis.Methods A retrospective analysis was made on the two-dimensional(2D) ultrasonographic features(size,shape,margin,calcification,blood flow signals,etc.) of 84 breast cancer masses collected from June 2014 to August 2016 and axillary lymph node metastasis to determine the relationship between 2D ultrasonographic features of target breast cancer masses and axillary lymph node metastasis.Results Ultrasound results showed that axillary lymph node metastasis occurred in 50 cases.There were significant differences in marginal burr of mass and blood supply inside the mass between patients with axillary lymph node metastasis and patients without axillary lymph node metastasis(P<0.05,P<0.01).Axillary lymph node metastasis was prone to occur when there were burrs on the margin of breast cancer and abundant blood supply inside tumor masses.Conclusion The typical two-dimensional ultrasonographic manifestations in the margin of breast mass and the blood supply inside the mass appears in axillary lymph node metastasis of breast cancer,which is helpful to judge the lymph node metastasis.
Objective To investigate the correlation between ultrasonographic features of breast cancer masses and axillary lymph node metastasis.Methods A retrospective analysis was made on the two-dimensional(2D) ultrasonographic features(size,shape,margin,calcification,blood flow signals,etc.) of 84 breast cancer masses collected from June 2014 to August 2016 and axillary lymph node metastasis to determine the relationship between 2D ultrasonographic features of target breast cancer masses and axillary lymph node metastasis.Results Ultrasound results showed that axillary lymph node metastasis occurred in 50 cases.There were significant differences in marginal burr of mass and blood supply inside the mass between patients with axillary lymph node metastasis and patients without axillary lymph node metastasis(P<0.05,P<0.01).Axillary lymph node metastasis was prone to occur when there were burrs on the margin of breast cancer and abundant blood supply inside tumor masses.Conclusion The typical two-dimensional ultrasonographic manifestations in the margin of breast mass and the blood supply inside the mass appears in axillary lymph node metastasis of breast cancer,which is helpful to judge the lymph node metastasis.
引文
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[14] Tamaki K,Sasano H,Ishida T,et al.The correlation between ultrasonographic findings and pathologic features in breast disorders[J].Jpn J Clin Oncol,2010,40(10):905-912.
[15] 李青春,姜浩,刘进才,等.乳腺癌组织中VEGF的表达及其与微小钙化、毛刺征形成的关系[J].实用放射学杂志,2014,30(9):1470-1472.
[16] Yang Q,Liu HY,Liu D,et al.Ultrasonographic features of triple-negative breast cancer:a comparison with other breast cancer subtypes[J].Asian Pac J Cancer Prev,2015,16(8):3229-3232.
[17] 冷晓玲,黄国福,马富成.乳腺癌病灶大小与超声造影表现的相关性[J].中华超声影像学杂志,2015(4):324-327.
[18] 项文静,于鹏丽,吴敏.腋窝淋巴结转移与乳腺癌超声征象的相关性分析[J].肿瘤学杂志,2018,24(2):156-159.
[19] 曹秋月,黄敏,郭建峰,等.乳腺癌彩色多普勒超声表现与其大小及组织病理学类型的相关性[J].中国医学影像技术,2012,28(10):1852-1855.
[20] 钟鸣,刘英霞,翁剑华,等.乳腺癌腋窝淋巴结转移的危险因素[J].热带医学杂志,2018,18(1):43-46,139.
[21] 冯娅琴.彩色超声在乳腺癌患者新辅助化疗疗效评价中的应用价值[J].中华全科医学,2017,15(4):647-649.
[2] Torre LA,Bray F,Siegel RL,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.
[3] 张彦收,刘运江.乳腺癌手术治疗回顾和进展[J].现代肿瘤医学,2015,23(5):719-722.
[4] He ZY,Wu SG,Yang Q,et al.Breast cancer subtype is associated with axillary lymph node metastasis:aretrospective cohort study[J].Medicine (Baltimore),2015,94(48):e2213.
[5] Layeequr Rahman R,Crawford SL,Siwawa P.Management of axilla in breast cancer-The Saga continues[J].Breast,2015,24(4):343.
[6] Iflazoglu N,Ureyen O,Atahan MK,et al.A retrospective comparative study of image-guided excisional biopsy in high-risk non-palpable breast lesions:predictive factors for malignancy[J].J Breasth Health,2015,11(3):132-137.
[7] Bedi DG,Krishnamurthy R,Krishnamurthy S,et al.Cortical morphologic features of axillary lymph nodes as a predictor of metastasis in breast cancer:in vitro sonographic study[J].Am J Roentgenol,2008,191(3):646-652.
[8] G?ksu S,Bozcuk H,Koral L,et al.Factors predicting lapatinib efficacy in HER-2+metastatic breast carcinoma:does it work better in different histologic subtypes?[J].Indian J Cancer,2015,52(4):517.
[9] B?cker W.WHO classification of breast tumors and tumors of the female genital organs:pathology and genetics[J].Verh Dtsch Ges Pathol,2002,86:116-119.
[10] Ecanow JS,Abe H,Newstead GM,et al.Axillary staging of breast cancer:what the radiologist should know[J].Radiographics,2013,33(6):1589-1612.
[11] Stachs A,Thi A,Dieterich M,et al.Assessment of ultrasound features predicting axillary nodal metastasis in breast cancer:the impact of cortical thickness[J].Ultrasound Int Open,2015,1(1):E19-E24.
[12] Lee B,Lim AK,Krell J,et al.The efficacy of axillary ultrasound in the detection of nodal metastasis in breast cancer[J].Am J Roentgenol,2013,200(3):314-320.
[13] Abe H,Schmidt RA,Kulkarni K,et al.Axillary lymph nodes suspicious for breast cancer metastasis:sampling with US-guided 14-gauge core-needle Biopsy-Clinical experience in 100 patients[J].Radiology,2009,250(1):41-49.
[14] Tamaki K,Sasano H,Ishida T,et al.The correlation between ultrasonographic findings and pathologic features in breast disorders[J].Jpn J Clin Oncol,2010,40(10):905-912.
[15] 李青春,姜浩,刘进才,等.乳腺癌组织中VEGF的表达及其与微小钙化、毛刺征形成的关系[J].实用放射学杂志,2014,30(9):1470-1472.
[16] Yang Q,Liu HY,Liu D,et al.Ultrasonographic features of triple-negative breast cancer:a comparison with other breast cancer subtypes[J].Asian Pac J Cancer Prev,2015,16(8):3229-3232.
[17] 冷晓玲,黄国福,马富成.乳腺癌病灶大小与超声造影表现的相关性[J].中华超声影像学杂志,2015(4):324-327.
[18] 项文静,于鹏丽,吴敏.腋窝淋巴结转移与乳腺癌超声征象的相关性分析[J].肿瘤学杂志,2018,24(2):156-159.
[19] 曹秋月,黄敏,郭建峰,等.乳腺癌彩色多普勒超声表现与其大小及组织病理学类型的相关性[J].中国医学影像技术,2012,28(10):1852-1855.
[20] 钟鸣,刘英霞,翁剑华,等.乳腺癌腋窝淋巴结转移的危险因素[J].热带医学杂志,2018,18(1):43-46,139.
[21] 冯娅琴.彩色超声在乳腺癌患者新辅助化疗疗效评价中的应用价值[J].中华全科医学,2017,15(4):647-649.