Value of Contrast-enhanced Ultrasound in Sentinel Lymph Node after Primary Breast Cancer Resection

MA Qing-mei; LUO Jia; LI Jia-ping; HUANG Cai-xin; WEI Lai-na; LIN Ying; SHAO Nan; ZHENG Yan-ling

doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20230523.001

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Value of Contrast-enhanced Ultrasound in Sentinel Lymph Node after Primary Breast Cancer Resection

Clinical Research | 更新时间：2024-02-19

- Value of Contrast-enhanced Ultrasound in Sentinel Lymph Node after Primary Breast Cancer Resection
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 44, Issue 4, Pages: 663-667(2023)
- 作者机构：
  
  1.中山大学附属第一医院超声科，广东广州 510000
  2.中山大学附属第一医院甲乳外科，广东广州 510000
- 作者简介：
  
  ZHENG Yan-ling； E-mail： zhyanl@mail.sysu.edu.cn
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20230523.001
  CLC： R445.1
- Published：20 July 2023，
  
  Received：05 December 2022，
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马清梅,罗佳,李家平等.超声造影在乳腺癌原发灶切除后前哨淋巴结的价值[J].中山大学学报（医学科学版）,2023,44(04):663-667.

MA Qing-mei,LUO Jia,LI Jia-ping,et al.Value of Contrast-enhanced Ultrasound in Sentinel Lymph Node after Primary Breast Cancer Resection[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(04):663-667.
马清梅,罗佳,李家平等.超声造影在乳腺癌原发灶切除后前哨淋巴结的价值[J].中山大学学报（医学科学版）,2023,44(04):663-667. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20230523.001.

MA Qing-mei,LUO Jia,LI Jia-ping,et al.Value of Contrast-enhanced Ultrasound in Sentinel Lymph Node after Primary Breast Cancer Resection[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(04):663-667. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20230523.001.

摘要

目的

探讨早期乳腺癌原发灶切除术后经皮与经静脉超声造影（P-Ⅳ-CEUS）的联合使用在前哨淋巴结中的应用价值。

方法

回顾性分析42例外院早期乳腺癌原发灶切除术后患者的临床-影像资料，所有患者均在我院进行再次手术。术前行前哨淋巴结P-Ⅳ-CEUS检查，术中采用亚甲蓝示踪剂进行前哨淋巴结切除活检，分析超声造影和前哨淋巴结活检的检出率和假阴性率，以手术病理结果为金标准，探讨超声造影对前哨淋巴结的诊断效能。

结果

前哨淋巴结经皮超声造影（P-CEUS）的检出率和假阴性率分别为92.9%（39/42）和7.1%（3/42），亚甲蓝染色的检出率为100%（41/41），1例因穿刺证实为转移性进行新辅助治疗；P-Ⅳ-CEUS的敏感性、特异性、阳性预测值、阴性预测值、准确率分别为66.7%（2/3）、100%（37/37）、100%（2/2）、97.3%（36/37）、97.4%（38/39）。

结论

早期乳腺癌原发灶切除术后P-Ⅳ-CEUS的联合使用可精准检出前哨淋巴结并准确判断其性质，为术前减少有创前哨淋巴结活检提供可靠依据。

Abstract

Objective

To investigate the value of percutaneous and intravenous contrast-enhanced ultrasound（P-Ⅳ-CEUS） in sentinel lymph nodes（SLNs） after resection of early-stage primary breast cancer.

Methods

A retrospective analysis was done on the clinical and imaging data of 42 early breast cancer patients. Following primary tumor resection， all these patients underwent reoperation in our hospital. SLNs were examined by preoperative P-Ⅳ-CEUS and intraoperative sentinel lymph node biopsy（SLNB） was performed by using Methylene blue as a tracer. Then we analyzed the detection and false-negative rate in CEUS and SLNB respectively. By using the surgical pathological results as the gold standard， the diagnostic efficacy of CEUS for SLNs was explored.

Results

The detection rate and false negative rate of SLNs in percutaneous contrast-enhanced ultrasound （P-CEUS） were 92.9% （39/42） and 7.1% （3/42）， respectively. The detection rate in methylene blue staining was 100% （41/41） and one patient underwent neoadjuvant therapy due to biopsy-confirmed metastasis. The sensitivity， specificity， positive predictive value， negative predictive value and accuracy of P-Ⅳ-CEUS were 66.7% （2/3）， 100% （37/37）， 100% （2/2）， 97.3% （36/37） and 97.4% （38/39）， respectively.

Conclusions

P-Ⅳ-CEUS after resection of early-stage primary breast cancer can accurately detect SLNs and characterize their status， which is a reliable clinical basis for reducing invasive SLNB.

关键词

前哨淋巴结乳腺癌超声造影

Keywords

sentinel lymph nodes（SLNs）breast cancercontrast-enhanced ultrasound（CEUS）

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Related Institution

South China State Key Laboratory of Oncology， Department of Radiotherapy， Sun Yat-sen University Cancer Center

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Department ofRadiology，Guangdong Academy of Medical Sciences//Guangdong General Hospital

Department of Radiology，The Third Affiliated Hospital，Sun Yat-sen University

Department of Radiology，Guangzhou First People′s Hospital，Guangzhou Medical University

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