The Value Of Ultrasonic Elastography Combined With Conventional Ultrasound Scoring Method In Diagnosis Of Axillary Lymph Nodes In Breast Cancer

Objective To explore value of ultrasonic elastography combined with conventional ultrasound scoring method in diagnosis of axillary lymph nodes in breast cancer.Methods From December 2012 to July 2016,174 female breast cancer with 174 ipsilateral axillary lymph nodes underwent surgery in the Department of gastrointestinal surgery,the First Affiliated Hospital of Guangxi Medical University.All breast masses and ipsilateral axillary lymph nodes were confirmed by surgery and pathology.We employed two-dimensional ultrasound?color doppler flow imaging and ultrasonic elastography to investigate the ipsilateral 174 axillary lymph nodes in 174 female patients with breast cancer.Observing the sonographic and flow features of axillary lymph nodes,then measure the size of the lymph nodes,thickness of cortical and calculate the long diameter/short diameter ratio,The shape typig and the blood typing of axillary lymph nodes were classified and scored by two-dimensional ultrasound and color doppler flow imaging,respectively,and ultrasonic score was perfored on 174 patients ' s ipilateral axillary lymph nodes after elastography.Theaxillary lymph nodes ultrasonic score of each patient was measured by using a 0~6 points scoring system.Results The mean score between metastatic and non-metastatic axillary lymph nodes differed significantly(96 metastatic nodes,mean score3.67�1.72 vs 78 non-metastatic nodes,mean score1.41�1.30,P <0.05).Most metastatic lymph nodes ultrasonic score was 3~6 points,nonmetastatic lymph nodes was 0 and 1 points,there was significant difference between the ultrasonic score of metastatic axillary lymph nodes and that of non-metastasis.(P < 0.05).By receiver operating curve(ROC)analysis,the best critical value of the total score to diagnosis axillary lymph nodes metastasis was 3,the area under the ROC curve was0.845,with the sensitivity ? specificity and accuracy was 74.0% ?82.1%and77.6%,respectively.The ultrasonic score was equal or more than 3 for the sector value of metastatic and non metastatic axillary lymph nodes were statistically significant difference(P<0.05).Conclusions Ultrasonic elastography combined with conventional ultrasound scoring method in diagnosis of axillary lymph nodes in breast cancer showed a statistically significant difference,the total score of metastatic axillary lymph nodes was higher than that of non-metastasis.The best critical value of the total score to diagnosis axillary lymph nodes metastasis was 3,ultrasonic elastography combined with conventional ultrasound scoring method diagnosis of axillary lymph nodes metastasis in breast cancer has a certain clinical value.