Value of Ultrasound in Diagnosis of Breast Cancer with Axillary Sentinel Lymph Nodes: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHAOYu-ling ¹ , WANGYan ²

1. Ultrasound Department, Maternal and Child Health Hospital of Xinjiang, Huocheng 835200, China;
2. Department of Ultrasound, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China;

Corresponding?author：

Keywords：

Breast cancer; Ultrasonography; Lymphatic metastasis; Axillary sentinel lymph node; Systematic review; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.20140176

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the diagnostic value of ultrasound for breast cancer with axillary sentinel lymph nodes, so as to provide evidence for clinical decision-making. Methods We searched the databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CBM, CNKI, WanFang Data and VIP for studies about ultrasound in the diagnosis of breast cancer with axillary sentinel lymph nodes till December 31^st, 2013. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and methodological quality of the included studies was evaluated. Meta-analysis was then conducted using Meta-Disc 1.4 software. Results A total of 12 studies involving 2 188 cases were included. The pooled results of meta-analysis showed that sensitivity and specificity were 0.75 (95%CI 0.72 to 0.77) and 0.91 (95%CI 0.89 to 0.92), respectively; positive likelihood ratio and negative likelihood ratio were 6.54 (95%CI 4.68 to 8.89) and 0.22 (95%CI 0.15 to 0.33), respectively; diagnostic odds ratio was 33.59 (95%CI 17.87 to 63.12); and the AUC was 0.934 3. Conclusion Ultrasound is has relatively high value in diagnosis of breast cancer with axillary sentinel lymph nodes. However, due to the influence caused by the limited quality and various potential heterogeneity, more high quality RCTs with large sample size are needed to further verify the above conclusion.

Citation： ZHAOYu-ling, WANGYan. Value of Ultrasound in Diagnosis of Breast Cancer with Axillary Sentinel Lymph Nodes: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(9): 1077-1082. doi: 10.7507/1672-2531.20140176 Copy

1.	劉峰, 張炳英, 馬小平, 等.彩色多普勒超聲對乳腺癌腋下淋巴結轉移的診斷價值.寧夏醫學雜志, 2007, 4(22):267-268.
2.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3:25-38.
3.	李慧芳, 劉景萍, 趙亞婷, 等.乳腺癌前哨淋巴結活檢術和彩超診斷的隨機對照研究.中國醫藥導報, 2012, 9(28):91-95.
4.	鐘麗瑤, 曹澤民.經皮注射淋巴結超聲造影與常規超聲對乳腺癌前哨淋巴結的診斷價值比較.中國醫學影像學雜志, 2011, 19(2):92-95.
5.	秦霞, 章美武, 殷驊, 等.乳腺癌胸肌區域前哨淋巴結轉移的彩超診斷與病理對照分析.實用醫學雜志, 2009, 25(9):1455-1457.
6.	王玉龍, 董海燕, 李慶, 等.超聲定位下可疑淋巴結取樣在早期乳腺癌手術中的臨床研究.中華內分泌外科雜志, 2011, 5(3):167-169.
7.	於曉平, 孫紅光, 秦愛平.高頻彩超綜合分析對乳腺癌腋窩淋巴結定性診斷的價值探討.南京醫科大學學報, 2007, 27(1):106-107.
8.	趙志華, 王海霞, 方學東, 等.乳腺癌內乳淋巴結轉移的超聲診斷價值.中國臨床醫學影像雜志, 2008, 19(12):902-904.
9.	易珊林, 曹慶艷, 王瓊.乳腺癌腋窩淋巴結的超聲診斷與病理對照.山西醫科大學學報, 2009, 40(7):651-653.
10.	李洪林, 姜玉新, 郝玉芝, 等.超聲診斷乳腺癌腋窩淋巴結轉移的價值.中華醫學超聲雜志(電子版), 2006, 3(4):237-239.
11.	孫嶺, 徐勇, 張晟, 等.超聲對乳腺癌腋窩淋巴結的診斷價值.中華超聲影像學雜志, 2007, 16(10):886-888.
12.	李大強, 李燕.腋窩淋巴結聯合原發病灶超聲診斷乳腺癌腋淋巴結轉移的價值.中國生育健康雜志, 2011, 22(4):205-207.
13.	趙紅梅, 張恒偉, 郭曉霞.高頻超聲對乳腺癌區域淋巴結轉移的診斷意義.中國實用醫刊, 2012, 39(10):15-16.
14.	Lee B, Lim AK, Krell J, et al. The efficacy of axillary ultrasound in the detection of nodal metastasis in breast cancer. AJR, 2013, 200:W314-W320.
15.	Liu WH, Zheng K, Jin AP, et al. Diagnostic evaluation of full-field digital mammography for nonpalpable breast cancer. Journal of Practical Radiology, 2004, 20(9):834-836.
16.	侯新燕, 矯健, 朱潔, 等.超聲光散射乳腺成像技術在乳腺疾病診斷中的應用.中國超聲醫學雜志, 2008, 24(4):315-318.
17.	Hill AD, Tran KN, Akhurst T, et al. Lessons learned from 500 cases of lymphatic mapping for breast cancer. Ann Surg, 1999, 299(4):528-535.
18.	Jansen L, Doting MHE, Rutgers EJT, et al. Clinical relevance of sentinel lymph nodes outside the axilla in patients with breast cancer. British Journal of Surgery, 2000, 87(7):920-925.
19.	Lee AHS, Ellis IO, Pinder SE, et al. Pathological assessment of sentinel lymph-node biopsies in patients with breast cancer. Virchows Arch, 2000, 436(2):97-101.
20.	Mansel RE, Khonji NI, Clarke D, et al. History, present status and future of sentinel node biopsy in breast cancer. Acta Oncologica, 2000, 39(3):265-268.
21.	Krastan C, Herneth AM, Formanek M, et al. Modem imaging lymph node staging of the head and neck region. EurJ Radiol, 2006, 58(3):360-366.
22.	歐亞夢蘭, 李力, 高琨. TERC基因對宮頸高級別病變(≥CIN Ⅱ)診斷價值的Meta分析.中國循證醫學雜志, 2013, 13(3):325-331.

1. 劉峰, 張炳英, 馬小平, 等.彩色多普勒超聲對乳腺癌腋下淋巴結轉移的診斷價值.寧夏醫學雜志, 2007, 4(22):267-268.
2. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3:25-38.
3. 李慧芳, 劉景萍, 趙亞婷, 等.乳腺癌前哨淋巴結活檢術和彩超診斷的隨機對照研究.中國醫藥導報, 2012, 9(28):91-95.
4. 鐘麗瑤, 曹澤民.經皮注射淋巴結超聲造影與常規超聲對乳腺癌前哨淋巴結的診斷價值比較.中國醫學影像學雜志, 2011, 19(2):92-95.
5. 秦霞, 章美武, 殷驊, 等.乳腺癌胸肌區域前哨淋巴結轉移的彩超診斷與病理對照分析.實用醫學雜志, 2009, 25(9):1455-1457.
6. 王玉龍, 董海燕, 李慶, 等.超聲定位下可疑淋巴結取樣在早期乳腺癌手術中的臨床研究.中華內分泌外科雜志, 2011, 5(3):167-169.
7. 於曉平, 孫紅光, 秦愛平.高頻彩超綜合分析對乳腺癌腋窩淋巴結定性診斷的價值探討.南京醫科大學學報, 2007, 27(1):106-107.
8. 趙志華, 王海霞, 方學東, 等.乳腺癌內乳淋巴結轉移的超聲診斷價值.中國臨床醫學影像雜志, 2008, 19(12):902-904.
9. 易珊林, 曹慶艷, 王瓊.乳腺癌腋窩淋巴結的超聲診斷與病理對照.山西醫科大學學報, 2009, 40(7):651-653.
10. 李洪林, 姜玉新, 郝玉芝, 等.超聲診斷乳腺癌腋窩淋巴結轉移的價值.中華醫學超聲雜志(電子版), 2006, 3(4):237-239.
11. 孫嶺, 徐勇, 張晟, 等.超聲對乳腺癌腋窩淋巴結的診斷價值.中華超聲影像學雜志, 2007, 16(10):886-888.
12. 李大強, 李燕.腋窩淋巴結聯合原發病灶超聲診斷乳腺癌腋淋巴結轉移的價值.中國生育健康雜志, 2011, 22(4):205-207.
13. 趙紅梅, 張恒偉, 郭曉霞.高頻超聲對乳腺癌區域淋巴結轉移的診斷意義.中國實用醫刊, 2012, 39(10):15-16.
14. Lee B, Lim AK, Krell J, et al. The efficacy of axillary ultrasound in the detection of nodal metastasis in breast cancer. AJR, 2013, 200:W314-W320.
15. Liu WH, Zheng K, Jin AP, et al. Diagnostic evaluation of full-field digital mammography for nonpalpable breast cancer. Journal of Practical Radiology, 2004, 20(9):834-836.
16. 侯新燕, 矯健, 朱潔, 等.超聲光散射乳腺成像技術在乳腺疾病診斷中的應用.中國超聲醫學雜志, 2008, 24(4):315-318.
17. Hill AD, Tran KN, Akhurst T, et al. Lessons learned from 500 cases of lymphatic mapping for breast cancer. Ann Surg, 1999, 299(4):528-535.
18. Jansen L, Doting MHE, Rutgers EJT, et al. Clinical relevance of sentinel lymph nodes outside the axilla in patients with breast cancer. British Journal of Surgery, 2000, 87(7):920-925.
19. Lee AHS, Ellis IO, Pinder SE, et al. Pathological assessment of sentinel lymph-node biopsies in patients with breast cancer. Virchows Arch, 2000, 436(2):97-101.
20. Mansel RE, Khonji NI, Clarke D, et al. History, present status and future of sentinel node biopsy in breast cancer. Acta Oncologica, 2000, 39(3):265-268.
21. Krastan C, Herneth AM, Formanek M, et al. Modem imaging lymph node staging of the head and neck region. EurJ Radiol, 2006, 58(3):360-366.
22. 歐亞夢蘭, 李力, 高琨. TERC基因對宮頸高級別病變(≥CIN Ⅱ)診斷價值的Meta分析.中國循證醫學雜志, 2013, 13(3):325-331.

Chinese Journal of Evidence-Based Medicine

Value of Ultrasound in Diagnosis of Breast Cancer with Axillary Sentinel Lymph Nodes: A Meta-Analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content