摘要
目的:探讨乳腺癌患者腋窝淋巴结转移的危险因素及 X 线与 CT 检查的诊断效能比较.方法:选取2021 年1 月至2023 年5 月在我院治疗的乳腺癌患者112 例,分析发生和未发生腋窝淋巴结转移患者临床资料差异;同时分析X线、CT 检查诊断腋窝淋巴结转移的价值.结果:112 例患者中,腋窝淋巴结转移患者32 例,腋窝淋巴结转移率为28.57%;发生腋窝淋巴结转移患者组织低分化比例、组织类型为浸润性癌比例、有脉管浸润比例、肿瘤直径≥5cm比例、组织Ki-67 表达≥14%比例分别为68.75%、90.63%、28.13%、31.25%和84.38%,明显高于未发生腋窝淋巴结转移患者(P<0.05);Logistic 回归分析显示:分化程度、病灶组织类型、脉管浸润、Ki-67 表达是乳腺癌患者发生腋窝淋巴结转移的影响因素(P<0.05);X线诊断腋窝淋巴结转移与病理结果一致性 Kappa 值为 0.500,P<0.05,一致性较差;CT诊断腋窝淋巴结转移与病理结果一致性 Kappa 值为 0.825,P<0.05,一致性较好;CT 诊断腋窝淋巴结转移的准确性、灵敏性和阴性预测值分别为 92.86%、87.50%和 95.00%,明显高于 X 线检查(P<0.05).结论:乳腺癌患者腋窝淋巴结转移受分化程度、病灶组织类型、脉管浸润、Ki-67 表达的影响;相较于X线,CT诊断腋窝淋巴结转移的价值较高.
Abstract
Objective:To explore the risk factors of axillary lymph node metastasis in breast cancer pa-tients and compare the diagnostic efficacy of X-ray and CT examinations.Methods:A total of 112 breast cancer patients treated in our hospital from January 2021 to May 2023 were selected.Differences in clinical data between patients with and without axillary lymph node metastasis were analyzed.The diagnostic value of X-ray and CT examinations for axillary lymph node metastasis was also assessed.Results:Among the 112 pa-tients,32 had axillary lymph node metastasis,lymph node metastasis rate was 28.57%.The proportion of pa-tients with axillary lymph node metastasis with low differentiation,invasive cancer,vascular infiltration,tumor diameter≥5cm,and Ki-67 expression≥14%were 68.75%,90.63%,28.13%,31.25%,and 84.38%,respectively,which were significantly higher than those without axillary lymph node metastasis(P<0.05).Logistic regression analysis showed that differentiation degree,focus tissue type,vascular invasion,Ki-67 ex-pression were the influencing factors of axillary lymph node metastasis in breast cancer patients(P<0.05).The consistency between X-ray diagnosis of axillary lymph node metastasis and pathological results was poor,with a Kappa value of 0.500 and P<0.05.The consistency between CT diagnosis of axillary lymph node me-tastasis and pathological results was good,with a Kappa value of 0.825 and P<0.05.The sensitivity,accura-cy,and negative predictive values of CT in diagnosing axillary lymph node metastasis were 92.86%,87.50%,and 95.00%,respectively,which were significantly higher than those of X-ray examination(P<0.05).Conclusion:The occurrence of axillary lymph node metastasis in breast cancer patients is influenced by differentiation degree,lesion tissue type,vascular invasion,and Ki-67 expression.Compared to X-ray,CT demonstrates higher diagnostic value for axillary lymph node metastasis.
基金项目
河北省承德市科技计划自筹经费项目(202204A068)
维普
万方数据