Clinical Examination Combined With Cellular And Pathological Examination Predicted Axillary Lymph Node Metastasis In Early Breast Cancer

Objective:To study the predictive effect of palpation,breast b-ultrasound,molybdenum target X-ray,ultrasound-guided coarse needle puncture and ultrasound-guided fine needle puncture for Axillary lymph node(ALN)metastasis of early breast cancer among 1500 patients who were operated in the breast disease diagnosis and treatment center of the first hospital of jilin university on December 31,2018.Methods:The medical records of 1,500 patients who underwent surgery in the center for breast disease diagnosis and treatment,the first hospital of jilin university on October 1,2015 and December 31,2018 were collected and calculated using Excel 2007 spreadsheet.Respectively analyzed palpate + imaging(breast ultrasound,molybdenum target X-ray),palpation + imaging(breast ultrasound,molybdenum target X-ray)+ coarse pathology biopsy needle under the guidance of ultrasound,palpation + imaging(breast ultrasound,molybdenum target X-ray)+ coarse pathology biopsy needle under the guidance of ultrasound,ultrasound guided fine-needle aspiration cytology puncture on the early prediction effect of axillary lymph node metastasis of breast cancer.SPSS 22.0 statistical software was used for data analysis.Counting data are represented by frequency or rate.The diagnostic effect of each diagnostic method was expressed by calculating the sensitivity,specificity,positive predictive value and negative predictive value.Chi-square test was used to compare the rates.The effects of the three combined examinations were further analyzed from the stages(T1,T2),molecular typing and hormone receptor levels.P <0.05 was considered statistically significant.Results:The sensitivity,specificity,positive predictive value and negative predictive value of palpation + imaging(b-ultrasonography and molybdenum target X-ray)for predicting axillary lymph node metastasis of early breast cancer were 71.05%,95.09%,82.82% and 90.79%,respectively,and the AUC value was 0.831.The sensitivity,specificity,positive predictive value and negative predictive value of palpation + imaging(breast B ultrasound,molybdenum target X-ray)+ thick needle pathology for predicting axillary lymph node metastasis of early breast cancer were 83.64%,100.00%,100.00% and 96.79%,respectively,and the AUC value was 0.918.The sensitivity,specificity,positive predictive value and negative predictive value of palpation + imaging(breast B ultrasound,molybdenum target X-ray)+ thick needle pathology + fine needle cytology were 85.71%,100.00%,100.00% and 68.75%,respectively,and the AUC value was 0.929.The three combined examinations were analyzed from the stages(T1 and T2),molecular typing and hormone receptor levels.In the stages(T1 and T2)stratification,the sensitivity,specificity,positive predictive value and negative predictive value of each combined examination for T2 stage were higher than those for T1 stage.In the stratification of molecular typing,the sensitivity,specificity,positive predictive value and negative predictive value of Luminal B were higher than those of the other three molecular typing.In the stratification of hormone receptor,the sensitivity,specificity and positive predictive value of each combination examination for HR-were all higher than HR+.Conclusion:1.In the screening of axillary lymph node metastasis of early breast cancer,the combined prediction effect of palpation + imaging is better than that of single examination.2.On the basis of screening,if further diagnosis is made,it should be combined with ultrasound-guided coarse needle puncture pathological examination and ultrasound-guided fine needle puncture cytology examination.3.Palpate,imaging and pathological + fine coarse needle cytology of the joint inspection of axillary lymph node metastasis of breast cancer early prediction value is superior to palpate + imaging,coarse needle pathology of the joint inspection,two kinds of joint inspection of predictive value for early axillary lymph node metastasis of breast cancer were superior to palpate + imaging effect of the joint inspection.