摘要目的 研究超声引导细针穿刺(FNA)对乳腺癌腋下转移淋巴结的诊断价值,并且与常规超声对乳腺癌转移淋巴结的诊断价值对比.方法 前瞻性入组于我院手术,术前超声诊断肿瘤BI-RADS分类4类或5类,肿瘤最大径线≤2 cm,术前相关检查未发现远处转移的乳腺疾病患者500例.每例均行常规超声腋下检查,同时行超声引导FNA后细胞学检查,以最终病理结果为标准,比较两种方法的诊断效能.结果 常规超声诊断的敏感度为 60.6%,特异度为 67.6%,阳性预测值为 77.2%,阴性预测值为 48.7%,准确度为 63.1%.超声引导FNA诊断乳腺癌腋下淋巴结的敏感度为78%,特异度为100%,阳性预测值为100%,阴性预测值为 71.6%,准确度为 85.6%.两种诊断方法比较,差异具有统计学意义(χ2=113.2,P<0.001).结论 超声引导FNA可以有效减少前哨淋巴结活检的数量,具有一定的临床价值.

abstractsObjective To study the value of ultrasound-guided fine needle aspiration (FNA) in the diagnosis of axillary lymph node metastasis in breast cancer,and to compared with conventional ultrasound in the diagnosis of metastatic lymph nodes of breast cancer.Methods Five hundred patients were enrolled into study prospectively from our hospital.The set of standard for patients into study:patients were diagnosed by BI-RADS and classified into class 4 or class 5 preoperative,the maximum diameter of the tumor was less than 2 cm,and there was no case of distant metastasis.Ultrasound guided FNA was performed in each case,and the results were compared with conventional ultrasound diagnosis results,using pathological findings as gold standard.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy in the diagnosis of axillary lymph node by conventional ultrasound were 60.6%,67.6%,77.2%,48.7%,and 63.1%,respectively,and by ultrasound-guided FNA were 78%,100%,100%,71.6%,and 85.6%,respectively.There were significant differences between the two diagnostic methods statistically(χ2=113.2,P<0.001).Conclusions Ultrasound-guided FNA can effectively reduce the number of sentinel lymph node biopsy,which displays a certain clinical value.