| PartⅠValue of contrast-enhanced ultrasound and nano-carbon staining in the localization of sentinel lymph node in breast cancerObjective:To investigate the value of contrast-enhanced ultrasound and nano-carbon staining in the diagnosis of sentinel lymph node in breast cancer.Methods:From May 2016 to May 2017,71 patients with pathologically confirmed breast cancer who were admitted to Shanxi Provincial Tumor Hospital were included in this study.The sulfur hexafluoride when ultrasound solution injected into the lesion side areola 3,6,9,12 o ’clock or subcutaneous tissue around the tumor,menstruation lymphography parallel thread sentinel lymph node position is determined,then before the operation will be in the same way of nano carbon suspension liquid injected into the subcutaneous of sentinel lymph node staining.Intraoperative sentinel lymph node resection was performed,and the pathological results were taken as the gold standard,and the data were classified and counted.Results:There were 31 patients with metastasis,40 patients without metastasis,31 patients in the metastatic group had at least one metastatic sentinel lymph node for guidewire localization,none of them missed diagnosis,the accuracy was 100%,and the rate of missed diagnosis was 0%.The accuracy of ultrasonography combined with nano carbon staining was 96.52%,the sensitivity was 100%,the specificity was 95.17%,the positive predictive value was 28.88,the negative predictive value was 100%,and the Jordan index was 0.95.Conclusion:The contrast and authenticity of contrast-enhanced ultrasound and nano-carbon staining for the sentinel lymph node of breast cancer is superior to that of ultrasound-guided guide wire and simple nano-carbon staining.Two-dimensional ultrasound and contrast-enhanced ultrasound are useful for the selection of suspicious metastasis sentinel nodes.,The accuracy of sentinel lymph node location under ultrasound guidance reaches a high level,so that it can accurately locate and provide assistance for clinical work.PartⅡThe Multivariate Analysis of Metastasis of Sentinel Lymph Node in Breast CancerObjective:To investigate the main factors associated with sentinel lymph node metastasis in invasive ductal carcinoma of the breast.Methods:160 patients admitted to Shanxi Provincial Tumor Hospital from May 2016 to April2018 who were confirmed by postoperative pathology as invasive ductal carcinoma of breast were selected for analysis of factors affecting metastasis.The relevant factors included age,factors related to the primary tumor(location,size,morphology,boundary,echo,blood supply characteristics,presence or absence of microcalcification,pathologic subtypes,and scores)and related factors of sentinel lymph node itself(size,morphology,boundary,echo,blood supply characteristics,contrast enhancement features,and cortical thickness)total of 17 related factors.SPSS20.0 software was used for single factor analysis and multivariate logistic regression analysis.Results:Of the 160 cases of breast invasive ductal carcinoma included in this study,78 cases of sentinel lymph node metastasis accounted for 48.75% of all patients.Single factor analysis showed that the related influencing factors for primary focal maximum diameter,primary focal position,primary focal pathologic grading,sentinel lymph node echoes detected,sentinel lymph node cortical thickness and sentinel lymph node contrast enhancement features detected detected six influence factors,such as the difference was statistically significant(P < 0.05).Multivariate Logistic regression results showed the maximum diameter of the primary lesion(OR=1.411,95%ci: 1.029-1.936),cortical thickness of sentinel lymph node(OR=8.338,95%ci: 1.622-42.873),contrast-enhanced features of sentinel lymph node(OR=26.519,95%ci :5.207-135.068).Peripheral enhancement: OR=5.415,95%CI:1.187-24.697;Heterogeneous enhancement: OR=17.687,95%CI:3.936-79.475)Conclusion:This study whether breast infiltrating ductal carcinoma of the sentinel lymph node metastases are influenced by many factors,mainly has the primary focal maximum diameter,cortical thickness of sentinel lymph node and contrast enhancement characteristics of sentinel lymph node,should be in the future diagnostic work pay more attention to the three may indicate a sign of sentinel lymph node transfer detected,improve the diagnostic accuracy and clinical work to promote efficiency and smoothly. |
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