Analysis Of Predictive Value Of Color Doppler Ultrasonography Combined With Clinical Pathological Factors In Sentinel Lymph Node Status Of Breast Cancer

BackgroundBreast cancer is the most malignant tumor in women.According to the International Agency for Research on Cancer(IARC),the number of new cases of breast Cancer in 2008 was 1.38 million,accounting for 22.9% of all female malignant tumors.About 460,000 women died of breast cancer,accounting for 13.7% of all female malignant tumors,and 1.7% of all female deaths.And this number is still on the rise,so more efforts are needed to treat and study breast cancer.One of the most important prognostic factors in early female breast cancer is the state of the axillary lymph nodes.The sentinel lymph node(sentinel lymph node,the SLNS)is the first stop in the metastatic of lymph nodes,thus SLNB has become the standard of evaluating whether the cancer cells transfer along the lymphatic metastasis.Because sentinel lymph node biopsy has the advantage of high sensitivity,low false negative rate and small injury,it has gradually replaced ALND as the standard operation for early breast cancer.But,sentinel lymph node biopsy still has significant postoperative complications.At the same time,the use of SLNB for all patients without screening results in a waste of medical resources.There have been several models predicting sentinel lymph node status in the past,but there are few studies on the prediction of sentinel node status by combining color doppler ultrasound and clinicopathological data.ObjectiveTo explore the correlation betteen entinel lymph nodal status and clinicopathological characteristics in patients with early breast carcinoma,in order to guide the application of sentinel lymph node biopsy(SLNB).Methodsclinical data of 1491 patients with early breast cancer were retrieved from Henan Tumor Hospital.Chi-square test and Logistic multivariate regression analysis were carried out to identify relevant factors predictive of entinel limph nodal status.A probability level(P < 0.05)was considered statistically significant.Results1 The group was consisted of 1491 patients whose ages ranged from 19 to 84 years old with an average of 48.8±10.5 years in age.27%(403/1491)positive sentinel lymph nodes were found in all patients,and the mean number of sentinel lymph node removed by the surgeon was 4.43±2.42.2 In the univariate analysis,the incidence of entinel lymph node metastasis(ELNM)was significantly associated with tumor size,tumor location,menopausal status,limph node aspect ratio,the number of limph node and major axis,pathological type,ER,PR,Ki-67 expression(P < 0.05),while age and HER-2 status were irrelevant(P > 0.05).3 In multivariate analyse,tumor size,pathological type,menopausal status,ER receptor status,limph node aspect ratio and major axis were the independent risk factors of ELNM(P < 0.05).4 the new model was accurate and discriminating(with an AUC of 0.731 when applied to the modeling group,sensitivity is 88.6 percent and the specificity is 83.7 percent).ConclusionsThe tumor size,pathological type,menopausal status,ER receptor status,limph node aspect ratio and major axis were the independent risk factors of ELNM.In all,the logistic regression model has a good diagnostic efficacy in the diagnosis of benign and malignant axillary limph nodes,also has better sensitivity and specificity.