Clinical effect of preoperative enhanced CT combined with sentinel lymph node biopsy in the evaluation of axillary lymph nodes in breast cancer
术前增强CT联合前哨淋巴结活检对乳腺癌腋窝淋巴结评估的临床效果

摘要

目的 探究在乳腺癌腋窝淋巴结评估中，开展术前增强CT联合前哨淋巴结活检的应用效果。方法 回顾性选择2024年1月至2025年12月在我院进行治疗的32例乳腺癌患者纳入样本进行研究，所有患者均进行术前增强CT检查和前哨淋巴结活检（sentinel lymph node biopsy, SLNB）,将术后腋窝淋巴结清扫（axillary lymph node dissection, ALND）病理结果作为诊断的金标准，比较两种检查方式的诊断效能。结果 增强CT+SLNB检查的灵敏度、特异度和准确率均高于单纯增强CT检查（P＜0.05）。而且肿瘤直径≤2cm时，单纯增强CT检查的灵敏度、特异度和准确率均低于联合检查（P＜0.05）；肿瘤直径＞2cm时，单纯增强CT检查的灵敏度、特异度，准确率均得到显著提升，但仍低于联合检查，其中灵敏度和准确率与联合检查相比差异显著（P＜0.05），而特异度与联合检查相比差异无统计学意义（P>0.05）。结论 在乳腺癌腋窝淋巴结评估中，术前增强CT联合SLNB可有效提高检查的灵敏度、特异度和准确率，具有较高的临床应用价值。

Abstract

Objective To explore the application effect of preoperative contrast-enhanced CT combined with sentinel lymph node biopsy (SLNB) in the axillary lymph node assessment of breast cancer.
Methods A retrospective study was conducted on 32 breast cancer patients who underwent treatment in our hospital from January 2024 to December 2025. All patients underwent preoperative contrast-enhanced CT and SLNB. The postoperative axillary lymph node dissection (ALND) pathology results were used as the gold standard for diagnosis, and the diagnostic efficacy of the two examination methods was compared.
Results The sensitivity, specificity, and accuracy of the combined examination of contrast-enhanced CT and SLNB were higher than those of contrast-enhanced CT alone (P<0.05). Furthermore, when the tumor diameter was ≤2cm, the sensitivity, specificity, and accuracy of contrast-enhanced CT alone were lower than those of the combined examination (P<0.05); when the tumor diameter was >2cm, the sensitivity, specificity, and accuracy of contrast-enhanced CT alone were significantly improved, but still lower than those of the combined examination, with significant differences in sensitivity and accuracy compared to the combined examination (P<0.05), while there was no statistically significant difference in specificity compared to the combined examination (P>0.05).
Conclusion   In the axillary lymph node assessment of breast cancer, preoperative contrast-enhanced CT combined with SLNB can effectively improve the sensitivity, specificity, and accuracy of the examination, and has high clinical application value.