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[目的]比较B超、钼靶及二者联合检查对乳腺癌淋巴结显像的能力。[方法]收集武汉大学人民医院经病理证实的乳腺癌患者共118例,比较B超、钼靶及二者联合检查对淋巴结显像的灵敏度、特异性、误诊率、漏诊率、阳性预测值、阴性预测值及总符合率。[结果]超声检查的灵敏度为47.4%,特异性为73.7%,误诊率为26.3%,漏诊率为52.6%,阳性预测值为54.5%,阴性预测值为67.7%,总符合率为63.2%。钼靶检查的灵敏度为88.2%,特异性为24.0%,误诊率为76.0%,漏诊率为11.8%,阳性预测值为61.2%,阴性预测值为60.0%,总符合率为61.0%。二者联合检查的灵敏度为91.3%,特异性为15.4%,误诊率为84.6%,漏诊率为8.7%,阳性预测值为65.6%,阴性预测值为50.0%,总符合率为63.9%。超声检查结果与病理结果的一致性较弱(κ=0.215,P=0.035)。以淋巴结转移数目分层,3种方法的检出水平与转移数目无关。[结论]超声在术前诊断乳腺癌淋巴结转移方面优于钼靶、以及超声和钼靶联合检查。此外,乳腺癌淋巴结转移的影像学检出水平与淋巴结转移数目无关。
[Objective] To compare the ability of B-ultrasound, mammography and their combined detection of lymph node imaging in breast cancer. [Methods] A total of 118 breast cancer patients confirmed by pathology were collected from People’s Hospital of Wuhan University. The sensitivity, specificity, misdiagnosis rate, misdiagnosis rate, positive predictive value, Negative predictive value and total coincidence rate. [Results] The sensitivity, specificity and accuracy of ultrasonic examination were 47.4%, 73.7%, 26.3%, 52.6% respectively. The positive predictive value was 54.5%, negative predictive value was 67.7%, and the total coincidence rate was 63.2%. The sensitivity of mammography was 88.2%, specificity was 24.0%, misdiagnosis rate was 76.0%, misdiagnosis rate was 11.8%, positive predictive value was 61.2%, negative predictive value was 60.0%, the total coincidence rate was 61.0%. The combined sensitivity of the two methods was 91.3%, specificity was 15.4%, misdiagnosis rate was 84.6%, misdiagnosis rate was 8.7%, positive predictive value was 65.6%, negative predictive value was 50.0%, total coincidence rate was 63.9%. The consistency between the results of ultrasonography and pathological findings was weak (κ = 0.215, P = 0.035). With the number of lymph node metastasis stratified, the detection of the three methods has nothing to do with the number of metastases. [Conclusion] Ultrasound is superior to molybdenum target in the diagnosis of lymph node metastasis of breast cancer before operation, and the combined examination of ultrasound and mammography. In addition, the level of lymph node metastases detected in breast cancer was not related to the number of lymph node metastases.