■尽管在乳腺癌患者中通常使用超声(US)引导的细针穿刺(FNA)进行腋窝淋巴结(AN),根据基于美国研究结果的怀疑水平,关于AN-FNA的诊断性能的研究数量有限.这项研究比较了美国指导的AN-FNA在乳腺癌患者中的结果,区分进行分期和监视的人。
■对2017年在首尔三星医疗中心进行的767例连续AN-FNA手术进行了回顾性分析的横断面回顾性研究,乳腺癌患者的分期为654,监测为113。放射科医生进行了腋窝US检查,并在FNA之前将特定发现前瞻性地分类为AN报告和数据系统(AN-RADS)类别3-5。评估每个类别的恶性率。卡方检验,有或没有Bonferroni校正,或Fisher精确检验用于比较每个类别的分期组和监测组之间的恶性率.
■在767个AN-FNA中,424例(55.3%)为恶性。分期组的恶性率(59.5%)明显高于监测组(31.0%,P<0.0001)。AN-RADS类别的分布在组间不同(P=0.015),4A是最常见的。3、4A、4B,4C,和5如下:5.6%,36.0%,77.4%,87.7%,分期组为98.4%,和0.0%,9.7%,53.3%,88.9%,100%在监测组。仅在4A类中,两组之间的恶性率显着差异(P=0.0001)。
■根据AN-RADS类别的AN-FNA似乎是确定腋窝淋巴结状态的合适方法。分期组的乳腺癌患者中AN-FNA的总体恶性率高于监测组。根据怀疑程度,两组之间的差异仅在4A类中有统计学意义.
UNASSIGNED: Despite the common use of ultrasound (US)-guided fine-needle aspiration (FNA) for axillary node (AN) in breast cancer patients, only a limited number of studies are available regarding the diagnostic performance of AN-FNA according to the suspicion level based on US findings. This study compares the outcomes of US-guided AN-FNA in breast cancer patients, differentiating between those undergoing staging and surveillance.
UNASSIGNED: A cross-sectional retrospective study with retrospective analysis was conducted on 767 consecutive AN-FNA procedures performed in 2017 at Samsung Medical Center in Seoul, with 654 for staging and 113 for surveillance in breast cancer patients. The radiologists performed axillary US and the specific finding was prospectively classified into the AN-reporting and data system (AN-RADS) category 3-5 before FNA. The malignancy rate of each category was evaluated. The chi-square test, with or without Bonferroni correction, or Fisher\'s exact test was used to compare the malignancy rates between the staging and surveillance groups for each category.
UNASSIGNED: Among the 767 AN-FNAs, 424 (55.3%) were malignant. The malignancy rate was significantly higher in the staging group (59.5%) than in the surveillance group (31.0%, P<0.0001). The distribution of AN-RADS categories differed between the groups (P=0.015), with 4A being the most common. The malignancy rates in categories 3, 4A, 4B, 4C, and 5 were as follows: 5.6%, 36.0%, 77.4%, 87.7%, and 98.4% in the staging group, and 0.0%, 9.7%, 53.3%, 88.9%, and 100% in the surveillance group. The malignancy rate was significantly different between the two groups only in category 4A (P=0.0001).
UNASSIGNED: AN-FNA according to AN-RADS category appears to be an appropriate method for determination of axillary nodal status. Overall malignancy rate of AN-FNA in breast cancer patients was higher in the staging group than in the surveillance group. According to the suspicion level, the difference between two groups was significant only in category 4A.