南方医科大学学报2016，Vol.36Issue(4)：493-499,7.
钼靶、CT与DCE-MRI评价乳腺癌淋巴结转移的价值
Value of mamography, CT and DCE-MRI in detecting axillary lymph node metastasis of breast cancer
摘要
Abstract
Objective To evaluate the diagnostic value of mammography, computed tomography (CT), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for axillary lymph node staging in breast cancer patients. Methods From February, 2014 to October, 2015, 109 women with breast cancer received examinations with preoperative mamography, CT, and DCE-MRI. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the 3 modalities were evaluated using histopathologic assessments as the gold standard. Results In total, 39.4% (43/109) of the patients had axillary lymph node metastasis. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of mamography for determining lymph node metastasis were 14.0%, 84.8%, 56.9%, 37.5% and 60.0%, respectively;those of CT were 93.0%, 57.6%, 71.6%,58.8%and 92.7%, and those of DCE-MRI were 95.3%, 65.2%, 77.1%, 64.1%and 95.6%, respectively. Compared with the histopathologic result, the Kappa coefficients of mamography, CT, and DCE-MRI were-0.13, 0.459 and 0.558, respectively. The specificity of mamography was significantly higher (P<0.05), but its sensitivity, accuracy, positive predictive value, and negative predictive value were significantly lower than those of CT and DCE-MRI (P<0.05). Compared with CT, DCE-MRI had significantly higher sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosis of lymph node metastasis (P<0.05). Conclusion DCE-MRI has a greater diagnostic power than CT and mammography, and CT has a greater diagnostic power than mammography for axillary lymph node metastasis in breast cancer patients. Mamography alone should be used cautiously for the diagnosis of lymph node metastasis.关键词
乳腺癌/淋巴结转移/钼靶/CT/DCE-MRIKey words
breast neoplasms/lymph node metastasis/mamography/CT/DCE-MRI引用本文复制引用
吴佩琪,刘春玲,刘再毅,叶维韬,梁长虹..钼靶、CT与DCE-MRI评价乳腺癌淋巴结转移的价值[J].南方医科大学学报,2016,36(4):493-499,7.基金项目
国家自然科学基金（81271654）；NSFC-广东联合基金（U1301258） Supported by National Natural Science Foundation of China (81271654) （81271654）
