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[目的]通过分析乳腺癌癌肿及其腋淋巴结的超声声像图表现,探讨癌肿及腋淋巴结超声声像图特征与病理学腋淋巴结转移的相关性。[方法]回顾性分析应用超声检出的145例乳腺癌患者及其278枚腋淋巴结的声像图表现,采用单因素分析、多因素Logistic回归及ROC曲线分析的方法,分别检测乳腺癌癌肿内血流特征及癌肿最大直径、腋淋巴结血流特征、径线比及最大皮质厚度与病理学腋淋巴结转移的相关性。[结果]单因素分析显示乳腺癌癌肿血流≥Ⅱ级者、癌肿直径较长者,对应病理学腋淋巴结转移率较高(P值均<0.05);周边型或混合型血流分布、径线比较小、皮质厚度较厚的腋淋巴结,其病理学淋巴结转移率较高(P值均<0.05)。多因素分析显示乳腺癌癌肿直径、淋巴结径线比和皮质最大厚度与病理学腋淋巴结转移明显相关。经ROC曲线分析,腋淋巴结最大皮质厚度是判定腋淋巴结转移的较佳指标。[结论]依据乳腺癌癌肿及腋淋巴结超声影像学特征评价腋淋巴结转移具有明显的临床实用价值。
[Objective] To investigate the correlation between the characteristics of ultrasonography of cancer and axillary lymph nodes and the pathological axillary lymph node metastasis by analyzing the sonographic findings of breast cancer and its axillary lymph nodes. [Methods] A retrospective analysis of 145 cases of breast cancer detected by ultrasound and 278 axillary lymph nodes were performed. Univariate analysis, multivariate logistic regression analysis and ROC curve analysis were used to detect breast cancer Intrahepatic flow characteristics and maximum diameter of cancer, characteristics of axillary lymph node blood flow, diameter-to-diameter ratio and maximal cortical thickness and pathological axillary lymph node metastasis. [Results] Univariate analysis showed that breast cancer with blood flow≥Ⅱ and those with longer cancer diameter had higher axillary lymph node metastasis (P <0.05), peripheral or mixed blood flow distribution (P <0.05). The pathological lymph node metastasis was higher in axillary lymph nodes with thicker cortical thickness. Multivariate analysis showed that breast cancer, cancer diameter, lymph node diameter ratio and the maximum thickness of the cortex and axillary lymph node metastasis was significantly correlated. The ROC curve analysis, axillary lymph node maximum cortical thickness is to determine the better indicator of axillary lymph node metastasis. [Conclusion] The evaluation of axillary lymph node metastasis based on the features of breast cancer and axillary lymph node imaging has obvious clinical value.