Relationship Between Axillary Lympf Node Metastasis And Multiple Ultrasound Features In Breast Cancer

Objective:This thesis aims to analyze the relationship between axillary lymph node metastasis and multiple ultrasound features in breast cancer patients,and improve the prediction of axillary lymph node metastasis of breast cancer through multiple ultrasound features and provide reference value for the clinical treatment of breast cancer.Methods:120 breast cancer patients who underwent surgery in our hospital were selected as subjects.The ultrasound sonographic features and clinical general data of the primary breast cancer were retrospectively analyzed.The results of pathological examination of axillary lymph node dissection in breast cancer patients were used as the gold standard to determine whether the patient had positive axillary lymph node metastasis.Univariate analysis was used to analyze multiple ultrasound features of breast cancer(including: lesion location(including lesion side,lesion quadrant),lesion maximum diameter,lesion aspect ratio,boundary,morphology,internal echo,microcalcification,Adler blood flow grading,the Peak Systolic Velocity(PSV),Resistance Index(RI),etc.)and clinical general data between the metastatic patients and non-metastatic patients.Multivariate logistic regression was used to determine the statistically significant factors in the univariate analysis as independent variables,whether axillary lymph node metastasis occurred as a dependent variable,and the relationship between axillary lymph node metastasis and multiple ultrasound features and clinical general data.Logistic regression prediction model of axillary lymph node metastasis in breast cancer was established.The logistic regression prediction model was established to predict the practical value of axillary lymph node metastasis in breast cancer.Results:1.Surgical and pathological diagnosis results: The pathological results of 120 patients with breast cancer confirmed 62 cases(51.67%)of axillary lymph node metastasis,and 58 cases(48.33%)of patients without axillary lymph node metastasis.2.Univariate analysis: There was no significant difference in the positive rate of axillary lymph node metastasis between the patients in the ?50-year-old group and the >50-year-old group(P >0.05).There was no statistical significance in the positive rate of axillary lymph node metastasis between the left side group and the right side group(P >0.05).There was no significant difference in the positive rate of axillary lymph node metastasis between the patients in the quadrant group(P >0.05).The positive rate of axillary lymph node metastasis was significantly higher in the patients with the largest diameter >2cm than Patients with ?2cm largest diameter(P <0.05);the positive rate of axillary lymph node metastasis in patients with lesion aspect ratio >1cm was significantly higher than that in patients with lesion aspect ratio ?1 group(P <0.05);There was no significant difference in the positive rate of axillary lymph node metastasis in the patients with clear lesion boundary and patients with unclear boundary of lesions(P >0.05).There was no significant difference in the positive rate of axillary lymph node metastasis between the patients in the rule group and the irregular shape of the lesions(P >0.05).There was no significant difference in the positive rate of axillary lymph node metastasis between the patients with internal echo heterogeneity(P >0.05).The axillary lymph node metastasis in the microcalcification group was observed.The positive rate was significantly higher than that in the microcalcification group(P <0.05).The positive rate of axillary lymph node metastasis was significantly higher in the blood flow classification group II-III than in the blood flow grade 0-I group(P <0.05).There was no significant difference in the positive rate of axillary lymph node metastasis between the patients with blood flow rate ?20cm/s and the highest blood flow rate>20cm/s group(P >0.05).The positive rate of axillary lymph node metastasis was significantly higher in patients with resistance index ? 0.70.The resistance index <0.70 patients(P <0.05);the positive rate of axillary lymph node metastasis in patients with suspicious lymph nodes was significantly higher than that in patients without suspicious lymph nodes(P <0.05).3.Multiple factors analysis: a multiariable Logistic regression analysis results show that the lesions microcalcification is visible in patients with breast cancer risk factors of axillary lymph node metastasis(OR = 2.180,P <0.05),blood flow class for?-? is breast cancer risk factors for axillary lymph node metastases(OR =12.159,P <0.05),axillary lymph node ultrasound is visible suspicious lymph nodes in patients with breast cancer risk factors of axillary lymph node metastasis(OR=7.750,P <0.05).Logistic regression prediction model:Logit(p)=Z=-7.142+0.821X4+2.511 X6.The accuracy of this model in predicting axillary lymph node metastasis of breast cancer is 90.00%.The area under the ROC curve was 0.938,the standard error was 0.010,and the 95% approximate reference value confidence interval was 0.924,0.958.Conclusion:1.Blood flow classification is grade II-III,axillary Lymph node ultrasound visible suspicious lymph nodes,microcalcification of lesions were risk factors of axillary lymph node metastasis in breast cancer patients,and axillary lymph node ultrasound suspicious was an important observation indicators of predictive predictor of axillary lymph node metastasis in breast cancer patients.2.The logistic regression analysis of the ultrasound diagnosis of axillary lymph node metastasis established by breast cancer in this study can analyze the interaction between each ultrasound characteristic factor and the importance of each diagnostic parameter in diagnosis.It has high diagnostic accuracy and has certain clinical practical value.