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

Video：

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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

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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.	刁骧, 艾昌林, 秦莉, 等译. QUADAS 的制定: 用于系统评价诊断性研究质量的工具. 中国循证医学杂志, 2007, 7(4): 296-306.
5.	张天嵩, 钟文昭. Meta-DiSc 软件在诊断试验 Meta 分析中的应用. 循证医学, 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. 超声弹性成像在判断乳腺癌腋淋巴结性质中的价值. 广州: 南方医科大学, 2013.
9.	赵巧玲, 阮骊韬, 张华, 等. 实时组织弹性成像对乳腺癌腋窝淋巴结转移的诊断价值评估. 西安交通大学学报(医学版), 2013, 34(5): 656-658, 663.
10.	赵文君. 超声弹性成像 ROI A 率联合弹性评分诊断腋窝淋巴结的价值. 兰州: 兰州大学, 2014.
11.	俞理, 胡兵, 林燕苹, 等. 实时组织弹性成像在乳腺癌腋窝淋巴结鉴别诊断中的应用. 上海交通大学学报(医学版), 2014, 34(10): 1511-1515.
12.	郑晓芳, 付赵虎, 于晶晶, 等. 常规超声联合超声弹性成像在腋窝淋巴结定性诊断中的价值. 现代肿瘤医学, 2015,14 (9): 1239-1241.
13.	周春华, 李艳宁, 徐丽芳, 等. 超声弹性成像和 CDFI 诊断乳腺癌腋窝淋巴结转移的比较研究. 广西医科大学学报, 2016, 32(1): 47-50.
14.	郭晓波, 刘颖, 包玉瑜, 等. 超声弹性成像技术对腋窝淋巴结性质的诊断价值. 现代生物医学进展, 2015, 15(6): 1109-1111, 1137.
15.	李慧芳, 刘景萍, 郑薇薇, 等. 高频彩色多普勒超声及弹性成像在乳腺癌腋淋巴结转移中的应用价值. 山西医药杂志, 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. 刁骧, 艾昌林, 秦莉, 等译. QUADAS 的制定: 用于系统评价诊断性研究质量的工具. 中国循证医学杂志, 2007, 7(4): 296-306.
5. 张天嵩, 钟文昭. Meta-DiSc 软件在诊断试验 Meta 分析中的应用. 循证医学, 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. 超声弹性成像在判断乳腺癌腋淋巴结性质中的价值. 广州: 南方医科大学, 2013.
9. 赵巧玲, 阮骊韬, 张华, 等. 实时组织弹性成像对乳腺癌腋窝淋巴结转移的诊断价值评估. 西安交通大学学报(医学版), 2013, 34(5): 656-658, 663.
10. 赵文君. 超声弹性成像 ROI A 率联合弹性评分诊断腋窝淋巴结的价值. 兰州: 兰州大学, 2014.
11. 俞理, 胡兵, 林燕苹, 等. 实时组织弹性成像在乳腺癌腋窝淋巴结鉴别诊断中的应用. 上海交通大学学报(医学版), 2014, 34(10): 1511-1515.
12. 郑晓芳, 付赵虎, 于晶晶, 等. 常规超声联合超声弹性成像在腋窝淋巴结定性诊断中的价值. 现代肿瘤医学, 2015,14 (9): 1239-1241.
13. 周春华, 李艳宁, 徐丽芳, 等. 超声弹性成像和 CDFI 诊断乳腺癌腋窝淋巴结转移的比较研究. 广西医科大学学报, 2016, 32(1): 47-50.
14. 郭晓波, 刘颖, 包玉瑜, 等. 超声弹性成像技术对腋窝淋巴结性质的诊断价值. 现代生物医学进展, 2015, 15(6): 1109-1111, 1137.
15. 李慧芳, 刘景萍, 郑薇薇, 等. 高频彩色多普勒超声及弹性成像在乳腺癌腋淋巴结转移中的应用价值. 山西医药杂志, 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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Chinese Journal of Evidence-Based Medicine

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

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