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首页> 外文期刊>Journal of Clinical Medicine Research >Preoperative Assessment of the Axilla by Surgeon Performed Ultrasound and Cytology in Patients With Breast Cancer
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Preoperative Assessment of the Axilla by Surgeon Performed Ultrasound and Cytology in Patients With Breast Cancer

机译：术前超声和细胞学检查对乳腺癌患者腋窝的术前评估

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Background: Preoperative evaluation of the axilla, an important prognostic determinant for patients with invasive breast cancer, is achieved by non- or minimally invasive methods to avoid the potential hazards of operative intervention. The aim of this study was to determine statistical power of axillary ultrasound (US) and US-guided fine needle aspiration cytology (FNAC) for evaluating axillary status.Methods: Axillary lymph nodes were imaged for malignant involvement by high resolution US in 93 breast cancer patients with clinically negative axilla. Cytological samples were obtained by US-guided FNAC from image-suspicious lymph nodes. Cytology-positive patients directly underwent axillary lymph node dissection (ALND). Patients with US and/or cytology-negative axilla underwent sentinel lymph node biopsy (SLNB). Using statistical analysis, US findings and US combined with FNAC were compared with SLNB and final pathology to measure performance.Results: US was suspicious for metastasis in 38 patients (41%), of whom 16 (42%) were cytology-positive. Axilla was positive in 36/93 patients (38.7%). Sixteen patients with positive FNAC directly underwent ALND. SLNB and/or final pathology was positive in 13/55 patients (23.7%) with negative US (false negative of US) and in 7/22 patients (31.8%) with positive US but negative cytology (false negative of FNAC). SLNB and/or final pathology was negative in 15/38 patients (39.5%) with positive US (false positive of US). Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of US alone were 63.8%, 73.6%, 69.8%, 60.5% and 76.3%, respectively, and 69.6%,100%, 81.6%, 100% and 68.1%, respectively, for US combined with FNAC.Conclusion: Statistical measures of the US alone did not achieve a satisfactory value for excluding operative biopsy. US-negative and US-positive but cytology-negative cases still require SLNB for accurate evaluation of axillary status. On the other hand, US-guided positive cytology can obviate SLNB proceeding directly to ALND and avoiding frozen section of sentinel node(s).J Clin Med Res. 2015;7(6):440-445doi: http://dx.doi.org/10.14740/jocmr2114w
机译：背景：腋窝的术前评估是浸润性乳腺癌患者的重要预后决定因素，可通过非浸润或微浸润方法来避免手术干预的潜在危险。这项研究的目的是确定腋窝超声（US）和美国引导的细针穿刺细胞学（FNAC）在评估腋窝状态方面的统计能力。方法：对93例乳腺癌中的高分辨率超声对腋窝淋巴结进行了恶性成像临床腋窝阴性的患者。细胞学样本是由美国引导的FNAC从可疑图像的淋巴结中获得的。细胞学阳性的患者直接接受了腋窝淋巴结清扫术（ALND）。 US和/或细胞学阴性的腋窝患者接受了前哨淋巴结活检（SLNB）。通过统计学分析，将US结果和US联合FNAC与SLNB和最终病理学进行比较，以评估性能。结果：US怀疑有转移的38例患者（41％），其中16例（42％）细胞学阳性。 Axilla在36/93例患者中阳性（38.7％）。 FNAC阳性的16例患者直接接受了ALND。在US阴性（US假阴性）的13/55患者（23.7％）和US阳性但细胞学阴性（FNAC假阴性）的7/22患者（31.8％）中，SLNB和/或最终病理学呈阳性。在US阳性（US假阳性）的15/38例患者中，SLNB和/或最终病理学阴性（39.5％）。仅美国的敏感性，特异性，准确性，阳性预测值（PPV）和阴性预测值（NPV）分别为63.8％，73.6％，69.8％，60.5％和76.3％，以及69.6％，100％，81.6％，美国联合FNAC分别为100％和68.1％。结论：仅美国的统计指标不能将手术活检排除在令人满意的数值之外。美国阴性和美国阳性但细胞学阴性的病例仍需要SLNB才能准确评估腋窝状态。另一方面，美国指导的阳性细胞学检查可避免SLNB直接进入ALND并避免前哨淋巴结的冷冻切片。 2015; 7（6）：440-445doi：http://dx.doi.org/10.14740/jocmr2114w

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