Diagnostic value of ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Xiaoguang ¹ , ZHANG Yu ² , ZHANG Xiaoli ³ ,  LU Xuefeng ¹ , ZHEN Yanhua ¹ , TIELIEWUHAN Nadire ⁴

1. Department of Ultrasound, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450014, P.R.China;
2. Department of Physical Examination, Health Management Institute of Xinjiang Medical University, Urumuqi, 830054, P.R.China;
3. Operating Room, People's Hospital of Zhecheng County, Shangqiu, 476200, P.R.China;
4. Ultrasound Diagnosis Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumuqi, 830054, P.R.China;

Corresponding?author：

LU Xuefeng, Email: luxuefeng2011@163.com

Keywords：

Axillary lymph node; Breast cancer; Ultrasonographic elastography; Diagnostic test; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.201610074

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ObjectiveTo systematically review the diagnostic value of the ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer.MethodsWe electronically searched the databases including The Cochrane Library, PubMed, CNKI, WanFang Data, VIP, MedaLink and CBM for studies about diagnostic value of the ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer from inception to October 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then meta-analysis was performed using MetaDisc 1.4 software.ResultsA total of 9 studies involving 735 lymph nodes were included. The results of meta-analysis showed that, the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio and DOR were 0.82 (95%CI 0.78 to 0.86), 0.76 (95%CI 0.72 to 0.81), 3.32 (95%CI 2.57 to 4.27), 0.25 (95%CI 0.20 to 0.31), and 14.77 (95%CI 10.20 to 21.38), respectively. The AUC of the SROC curve was 0.8741.ConclusionUltrasonographic elastography has high sensitivity and specificity in the differential diagnosis of axillary lymph nodes in breast cancer, which indicates that it can be used to diagnosis axillary lymph nodes in breast cancer.

Citation： ZHANG Xiaoguang, ZHANG Yu, ZHANG Xiaoli, LU Xuefeng, ZHEN Yanhua, TIELIEWUHAN Nadire. Diagnostic value of ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer: a systematic review. Chinese Journal of Evidence-Based Medicine, 2017, 17(8): 915-920. doi: 10.7507/1672-2531.201610074 Copy

1.	Zhi H, Xiao XY, Ou B, et al. Could ultrasonic elastography help the diagnosis of small (≤2 cm) breast cancer with the usage of sonographic BI-RADS classification. Eur J Radiol, 2012, 81(11): 3216-3221.
2.	Voutsadakis A, Spadafora S. Axillary lymphnode management in breast cancer with positive sentinel lymph node biopsy. World J Clin Oncol, 2015, 10(6): 1-6.
3.	Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology, 2006, 239(2): 341-350.
4.	刁驤, 艾昌林, 秦莉, 等譯. QUADAS 的制定: 用于系統評價診斷性研究質量的工具. 中國循證醫學雜志, 2007, 7(4): 296-306.
5.	張天嵩, 鐘文昭. Meta-DiSc 軟件在診斷試驗 Meta 分析中的應用. 循證醫學, 2008, 8(2): 97-100.
6.	Habel LA, Capra AM, Oestreicher N, et al. Mammographic density in a multiethnic cohort. Menopause, 2007, 14(5): 891-899.
7.	Choi JJ, Kang BJ, Kim SH, et al. Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. J Ultrasound Med, 2011, 30(4): 429-436.
8.	谷英士. 超聲彈性成像在判斷乳腺癌腋淋巴結性質中的價值. 廣州: 南方醫科大學, 2013.
9.	趙巧玲, 阮驪韜, 張華, 等. 實時組織彈性成像對乳腺癌腋窩淋巴結轉移的診斷價值評估. 西安交通大學學報(醫學版), 2013, 34(5): 656-658, 663.
10.	趙文君. 超聲彈性成像 ROI A 率聯合彈性評分診斷腋窩淋巴結的價值. 蘭州: 蘭州大學, 2014.
11.	俞理, 胡兵, 林燕蘋, 等. 實時組織彈性成像在乳腺癌腋窩淋巴結鑒別診斷中的應用. 上海交通大學學報(醫學版), 2014, 34(10): 1511-1515.
12.	鄭曉芳, 付趙虎, 于晶晶, 等. 常規超聲聯合超聲彈性成像在腋窩淋巴結定性診斷中的價值. 現代腫瘤醫學, 2015,14 (9): 1239-1241.
13.	周春華, 李艷寧, 徐麗芳, 等. 超聲彈性成像和 CDFI 診斷乳腺癌腋窩淋巴結轉移的比較研究. 廣西醫科大學學報, 2016, 32(1): 47-50.
14.	郭曉波, 劉穎, 包玉瑜, 等. 超聲彈性成像技術對腋窩淋巴結性質的診斷價值. 現代生物醫學進展, 2015, 15(6): 1109-1111, 1137.
15.	李慧芳, 劉景萍, 鄭薇薇, 等. 高頻彩色多普勒超聲及彈性成像在乳腺癌腋淋巴結轉移中的應用價值. 山西醫藥雜志, 2016, 45(5): 510-513.
16.	Tourasse C, Denier JF, Awada A, et al. Elastography in the assessment of sentinel lymph nodes prior to dissection. Eur J Radio, 2012, 81(11): 3154-3159.

1. Zhi H, Xiao XY, Ou B, et al. Could ultrasonic elastography help the diagnosis of small (≤2 cm) breast cancer with the usage of sonographic BI-RADS classification. Eur J Radiol, 2012, 81(11): 3216-3221.
2. Voutsadakis A, Spadafora S. Axillary lymphnode management in breast cancer with positive sentinel lymph node biopsy. World J Clin Oncol, 2015, 10(6): 1-6.
3. Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology, 2006, 239(2): 341-350.
4. 刁驤, 艾昌林, 秦莉, 等譯. QUADAS 的制定: 用于系統評價診斷性研究質量的工具. 中國循證醫學雜志, 2007, 7(4): 296-306.
5. 張天嵩, 鐘文昭. Meta-DiSc 軟件在診斷試驗 Meta 分析中的應用. 循證醫學, 2008, 8(2): 97-100.
6. Habel LA, Capra AM, Oestreicher N, et al. Mammographic density in a multiethnic cohort. Menopause, 2007, 14(5): 891-899.
7. Choi JJ, Kang BJ, Kim SH, et al. Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. J Ultrasound Med, 2011, 30(4): 429-436.
8. 谷英士. 超聲彈性成像在判斷乳腺癌腋淋巴結性質中的價值. 廣州: 南方醫科大學, 2013.
9. 趙巧玲, 阮驪韜, 張華, 等. 實時組織彈性成像對乳腺癌腋窩淋巴結轉移的診斷價值評估. 西安交通大學學報(醫學版), 2013, 34(5): 656-658, 663.
10. 趙文君. 超聲彈性成像 ROI A 率聯合彈性評分診斷腋窩淋巴結的價值. 蘭州: 蘭州大學, 2014.
11. 俞理, 胡兵, 林燕蘋, 等. 實時組織彈性成像在乳腺癌腋窩淋巴結鑒別診斷中的應用. 上海交通大學學報(醫學版), 2014, 34(10): 1511-1515.
12. 鄭曉芳, 付趙虎, 于晶晶, 等. 常規超聲聯合超聲彈性成像在腋窩淋巴結定性診斷中的價值. 現代腫瘤醫學, 2015,14 (9): 1239-1241.
13. 周春華, 李艷寧, 徐麗芳, 等. 超聲彈性成像和 CDFI 診斷乳腺癌腋窩淋巴結轉移的比較研究. 廣西醫科大學學報, 2016, 32(1): 47-50.
14. 郭曉波, 劉穎, 包玉瑜, 等. 超聲彈性成像技術對腋窩淋巴結性質的診斷價值. 現代生物醫學進展, 2015, 15(6): 1109-1111, 1137.
15. 李慧芳, 劉景萍, 鄭薇薇, 等. 高頻彩色多普勒超聲及彈性成像在乳腺癌腋淋巴結轉移中的應用價值. 山西醫藥雜志, 2016, 45(5): 510-513.
16. Tourasse C, Denier JF, Awada A, et al. Elastography in the assessment of sentinel lymph nodes prior to dissection. Eur J Radio, 2012, 81(11): 3154-3159.

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Diagnostic value of ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer: a systematic review

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