Clinical value of ultrasonography combined with tumor markers in the diagnosis of axillary lymph node metastasis of breast cancer
10.11855/j.issn.0577-7402.2020.10.09
- VernacularTitle: 超 声 联 合 肿 瘤 标 志 物 诊 断 乳 腺 癌 腋 窝 淋 巴 结 转 移 的 临 床价值分析
- Author:
Gao NA
1
Author Information
1. Department of Breast Surgery
- Publication Type:Journal Article
- Keywords:
Breast cancer;
Carcinoembryonic antigen;
Cytokeration 19;
Ultrasound
- From:
Medical Journal of Chinese People's Liberation Army
2020;45(10):1072-1076
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnostic value of preoperative ultrasound examination combined with cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) detection for axillary lymph node metastasis in breast cancer patients. Methods The data collected from 68 patients undergoing modified radical mastectomy in the Fifth Affiliated Hospital of Zhengzhou University from September 2018 to August 2019 were analyzed respectively. Taking the pathological diagnosis as the gold standard, the patients were divided into axillary lymph node metastasis group (n=38) and non-metastasis group (n=30). The relationship between the results of breast ultrasound, CK19 and CEA examination and axillary lymph node metastasis in the patients with breast cancer and the value of combined detection of the three items in the diagnosis of axillary lymph node metastasis were analyzed. Results Ultrasound examination results of the breast showed that the lymph nodes had ≥7 mm long diameter, blurred border uneven internal echo, and abundant blood flow signal in the lymph nodes, and the ratio of the longitudinal to transverse diameter was <2 in the metastasis group, and the detection rates of these indexes in the axillary lymph node metastasis group were higher than those in the non-metastatic group (P<0.05). The expression levels and positivity rates of CK19 and CEA in the axillary lymph node metastasis group were higher than those in the non-metastatic group (P<0.05). ROC curve analysis showed that the area under the ROC curve for the combined detection of CK19 and CEA (AUC=0.919) was significantly larger than that of CK19 (AUC=0.859) or CEA (AUC=0.849) alone, and the logistic regression equation was established: Logit(P)=-6.032+0.203×CK19+0.261×CEA. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CK19 for axillary lymph node metastasis were 89.5%, 40.0%, 65.4%, 75.0%, 67.6%, those of CEA were 92.1%, 56.7%, 72.9%, 85.0%, 76.5%, those of ultrasonography were 86.8%, 90.0%, 91.7%, 84.4%, 88.2%, and those of combined detection of the three were 97.4%, 40.0%, 67.3%, 92.3%, 72.1%. Conclusion On the basis of ultrasound investigation, taking CK19 and CEA as the joint detection index has a higher application value in predicting axillary lymph node metastasis of breast cancer.
