乳腺癌腋窝淋巴结声像图联合免疫组织化学与淋巴结转移的相关性研究

doi:10.3969/j.issn.1007-3969.2016.02.007

中国癌症杂志 ›› 2016, Vol. 26 ›› Issue (2): 155-160.doi: 10.3969/j.issn.1007-3969.2016.02.007

乳腺癌腋窝淋巴结声像图联合免疫组织化学与淋巴结转移的相关性研究

孔祥崇，程　文，郭存丽，尚海涛，张　娜

哈尔滨医科大学附属肿瘤医院超声科，黑龙江哈尔滨 150081

出版日期:2016-02-29 发布日期:2016-06-01
通信作者: 程　文　E-mail：chengwen69@yahoo.com

Correlation between axillary lymph node metastases and ultrasonographic characteristics of axillary lymph node combined with immunohistochemistry in breast cancer patients

KONG Xiangchong, CHENG Wen, GUO Cunli, SHANG Haitao, ZHANG Na

Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China

Published:2016-02-29 Online:2016-06-01
Contact: CHENG Wen E-mail: chengwen69@yahoo.com

摘要/Abstract

摘要： 背景与目的：乳腺癌腋窝淋巴结转移对于乳腺癌患者的预后及治疗方案的选择有重要的指导意义。本研究旨在探讨乳腺癌腋窝淋巴结声像图表现联合免疫组织化学与腋窝淋巴结转移的相关性。方法：回顾性分析应用超声检出的366例乳腺癌患者共计728枚腋窝淋巴结的声像图表现，采用单因素分析、多因素logistic回归及受试者工作特征(receiver operating characteristic，ROC)曲线分析的方法，分别检验乳腺癌腋窝淋巴结皮质最大厚度、长短径之比、皮髓质之比和淋巴结血流特征，联合乳腺癌术后免疫组织化学结果，研究其与病理学腋窝淋巴结转移的相关性。结果：依据单因素分析，腋窝淋巴结皮质最大厚度、长短径之比、血流特征以及乳腺癌病灶p53的阳性表达率与淋巴结转移有关(P<0.05)。依据多因素分析及ROC分析，腋窝淋巴结皮质最大厚度是判定腋窝淋巴结转移的最佳指标。腋窝淋巴结皮质最大厚度大于3 mm的患者，其乳腺癌病灶的p53阳性表达率(42.78%)明显高于皮质最大厚度小于等于3 mm的患者(25.82%)，差异有统计学意义(P<0.01)。结论：乳腺癌腋窝淋巴结声像图表现联合免疫组织化学评价腋窝淋巴结转移，对乳腺癌的临床诊疗方法选择具有重要价值。

关键词: 乳腺癌, 腋窝淋巴结转移, 超声, 免疫组织化学

Abstract: Background and purpose: Axillary lymph node metastasis of breast cancer has an important significance in prognosis and treatment of breast cancer. This study was to investigate the correlation between axillary lymph node metastasis and ultrasonographic characteristics of axillary lymph node combined with immunohistochemistry in breast cancer patients. Methods: A total number of 366 breast cancer patients were selected in this study. Seven hundred and twenty-eight axillary lymph nodes were collected. With ultrasonography, the maximum cortex thickness, the ratio of the height to the length, the ratio of the cortex to the medulla and blood flow of axillary lymph nodes were observed, in order to study the correlation between these indicators and axillary lymph node metastasis combined with the postoperative immunohistochemical results. Results: According to univariate analysis, axillary lymph node maximum cortex thickness, the ratio of the height to the length, characteristics of blood flow and the positive expression rate of p53 were related to axillary lymph node metastasis (P<0.05). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve showed that axillary lymph node maximum cortex thickness was the best indicator to determine axillary lymph node metastasis. The positive expression rate of p53 in patients with maximum cortex thickness >3 mm (42.78%) of axillary lymph node was significantly higher than that in patients with maximum cortex thickness ≤3 mm (25.82%) (P<0.01). Conclusion: Ultrasonographic characteristics of axillary lymph node and immunohistochemistry method are closely correlated with axillary lymph node metastasis in patients with breast cancer, which is important in diagnostic and treatment in clinic.

Key words: Breast cancer, Axillary lymph node metastasis, Ultrasound, Immunohistochemistry

孔祥崇,程　文,郭存丽,等. 乳腺癌腋窝淋巴结声像图联合免疫组织化学与淋巴结转移的相关性研究[J]. 中国癌症杂志, 2016, 26(2): 155-160.

KONG Xiangchong, CHENG Wen, GUO Cunli, et al. Correlation between axillary lymph node metastases and ultrasonographic characteristics of axillary lymph node combined with immunohistochemistry in breast cancer patients[J]. China Oncology, 2016, 26(2): 155-160.

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乳腺癌腋窝淋巴结声像图联合免疫组织化学与淋巴结转移的相关性研究

Correlation between axillary lymph node metastases and ultrasonographic characteristics of axillary lymph node combined with immunohistochemistry in breast cancer patients

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