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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Preoperative sonographic classification of axillary lymph nodes in patients with breast cancer: node-to-node correlation with surgical histology and sentinel node biopsy results.
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Preoperative sonographic classification of axillary lymph nodes in patients with breast cancer: node-to-node correlation with surgical histology and sentinel node biopsy results.

机译：乳腺癌患者腋窝淋巴结的术前超声分类：淋巴结与手术组织学和前哨淋巴结活检结果的相关性。

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OBJECTIVE: The purpose of this study was to prospectively evaluate the role of axillary lymph node classification by sonography in breast cancer patients by node-to-node correlation with surgical histology and sentinel node biopsy results. SUBJECTS AND METHODS: Between June 2006 and December 2006, preoperative axillary sonography was performed in 191 consecutive breast cancer patients (median age, 46 years; age range, 24-79 years) who had been scheduled to undergo breast cancer surgery with sentinel node biopsy. The axillary lymph node that had the thickest cortex or that was closest to the primary tumor was prospectively classified and then removed through sonographically guided needle localization. Correspondence about and histologic results for the needle-localized nodes and the radioactive sentinel nodes were analyzed. The rate of malignancy, according to the sonographic classification, and the area under a receiver operating characteristic curve were analyzed. RESULTS: Of the 191 needle-localized nodes, 41 (21%) had metastases and 150 (79%) did not have metastases. When a cutoff point of a cortical thickness of 2.5 mm was used, sonographic classification showed 85% (35/41) sensitivity, 78% (117/150) specificity, and an area under the curve of 0.861 (95% CI, 0.796-0.926). Of the 54 patients with metastases at sentinel node biopsy or axillary lymph node dissection, 13 (24%) had false-negative results of sonographically guided needle localization. Unsuccessful lymphatic mapping because of absent radiotracer uptake during sentinel node biopsy was found in 4% (7/191), whereas all needle-localized nodes with a cortical thickness of more than 2.5 mm were confirmed as metastases. CONCLUSION: Sonographic classification of axillary lymph nodes is effective for predicting the presence of metastases to avoid sentinel node biopsy or to reduce unsuccessful lymphatic mapping during sentinel node biopsy.
机译：目的：本研究旨在通过淋巴结与手术组织学和前哨淋巴结活检结果的相关性，前瞻性评估超声检查对乳腺癌腋窝淋巴结分类的作用。研究对象和方法：2006年6月至2006年12月，对191例计划行前哨淋巴结活检的乳腺癌手术的乳腺癌患者（中位年龄46岁;年龄范围24-79岁）进行了术前腋窝超声检查。 。将前皮质最厚或最接近原发肿瘤的腋窝淋巴结进行前瞻性分类，然后通过超声引导下的针头定位将其切除。分析了针定位节和放射性前哨节的对应关系和组织学结果。根据超声分类的恶性率和接收器工作特征曲线下的面积进行了分析。结果：在191个针状结节中，有41个（21％）有转移，而150个（79％）没有转移。当使用皮质厚度为2.5 mm的分界点时，超声分级显示灵敏度为85％（35/41），特异性为78％（117/150），曲线下面积为0.861（95％CI，0.796-）。 0.926）。在前哨淋巴结活检或腋窝淋巴结清扫术中转移的54例患者中，有13例（24％）的超声引导下针头定位结果为假阴性。在前哨淋巴结活检过程中，由于放射性示踪剂的摄取不足，导致淋巴标测不成功的比例为4％（7/191），而所有皮层厚度大于2.5 mm的针状定位结点均被确认为转移灶。结论：对腋窝淋巴结进行超声检查可有效预测转移灶的存在，从而避免前哨淋巴结活检或减少前哨淋巴结活检过程中淋巴标测的失败。

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