Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer
Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer
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DOI：
10.1007/s00595-007-3589-2
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发表时间：
2008-02-01
期刊：
影响因子：
2.5
通讯作者：
Ishihara, Setsuko
中科院分区：
文献类型：
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作者：
Ogasawara, Yutaka;Doihara, Hiroyoshi;Ishihara, Setsuko
目的。我们评估了多排计算机断层扫描 (MD-CT) 用于检测乳腺癌患者腋窝淋巴结状态 (ALNS) 的有效性。方法。我们回顾了 42 名乳腺癌患者。 MD-CT上的转移淋巴结定义为椭圆形或圆形，短轴超过5毫米。我们在术前通过触诊和 MD-CT 结果评估了 ALNS，并进行了前哨淋巴结活检 (SLNB) 和完整腋窝淋巴结清扫术 (ALND)。结果。对于建立 ALNS，MD-CT 的敏感性为 76.9%，特异性为 96.6%，准确性为 90.5%。根据MD-CT结果，42例患者中有4例被误诊，其中只有1例呈假阳性。另一方面，一名组织学阴性前哨淋巴结 (SLN) 结果的患者仅在非 SLN 中出现转移。术前MD-CT显示该患者淋巴结阳性。结论。多排计算机断层扫描有助于识别需要 ALND 而无需 SLNB 的女性，具有足够的阳性预测价值。通过仔细解释 MD-CT 显示的腋窝淋巴结，可以避免 SLNB 的假阴性检测。
Purpose. We evaluated the effectiveness of multidetector-row computed tomography (MD-CT) for detecting axillary lymph nodal status (ALNS) in patients with breast cancer.Methods. We reviewed 42 patients with breast cancer. A metastatic lymph node on MD-CT was defined as oval or round, with more than 5 mm on the short axis. We evaluated ALNS preoperatively by both palpation and MD-CT findings and performed sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection (ALND).Result. For establishing the ALNS, MD-CT showed a sensitivity of 76.9%, a specificity of 96.6%, and an accuracy of 90.5%. On the basis of the MD-CT findings, misdiagnosis was made in 4 of the 42 patients, only one of which was false positive. On the other hand, one patient with a histologically negative sentinel lymph node (SLN) result had metastasis only in a non-SLN. Preoperative MD-CT showed a positive node in this patient.Conclusions. Multidetector-row computed tomography assists in identifying women who require ALND without SLNB, with sufficient positive predictive value. Falsenegative detection by SLNB could be avoided with careful interpretation of the axillary lymph nodes shown by MD-CT.