Predictive Value of Conventional Ultrasound Combined with Contrast-enhanced Ultrasound in Axillary Lymph Node Metastasis for Invasive Breast Carcinoma of No Specific Type
Objective To analyze the predictive value of dual-modality ultrasound signs of invasive breast carcinoma of no specific type(IBC-NST)lesions on axillary lymph node metastasis.Methods The data of conventional ultrasound(US)and contrast-enhanced ultrasound(CEUS)signs of primary lesions in 252 patients with IBC-NST who were admitted to the First Central Hospital of Baoding from November 2021 to January 2023 were retrospectively collected.According to the pathological results after axillary lymph node dissection,they were divided into metastasis group(n=148)and non-metastasis group(n=104).The single-modality and dual-modality ultrasound Logistic regression prediction models were established by univariate and multivariate analysis,and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy of the three prediction models for axillary lymph node metastasis.Results There were significant differences in lesion size,microcalcification,Adler blood flow grading,location,radial convergence of the edge after enhancement,change of lesion range after enhancement,perforator vessels and perfusion defects between the metastatic group and the non-metastatic group(P<0.05).The results of multivariate analysis showed that when US and CEUS were jointly diagnosed,the Logistic regression prediction model Logit(P)=-3.870+1.875 Adler blood flow grade+1.112 perfusion defect+1.667 perforator vessel+1.820 changes in lesion range after enhancement,which predicted the area under the curve(AUC)(0.874)of axillary lymph node metastasis compared with US(0.689)and CEUS(0.827),the difference was statistically significant(Z=5.844,P<0.05;Z=2.887,P=0.004).Moreover,the sensitivity,specificity,accuracy,PPV and NPV of the dual-modality ultrasound prediction model were higher than those of the US and CEUS single-modality ultrasound prediction models,and the prediction efficiency was the best.Conclusion The dual-modality ultrasound prediction model combined with US and CEUS has high predictive value for early axillary lymph node metastasis in IBC-NST,and can provide reliable imaging basis for clinical prognosis evaluation.
Conventional ultrasoundContrast-enhanced ultrasoundInvasive breast carcinoma of no specific typeAxillary lymph node metastasis