Value of Ultrasound Contrast Agents Injected Subcutaneously for Diagnosing Sentinel Lymph Nodes of Breast Cancer: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGYan , NaDi-re D·Teliewuhan , MUYan ,  YAOLan-hui

Department of Ultrasound, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China;

Corresponding?author：

YAOLan-hui, Email: yaolanhui6082@yahoo.com.cn

Keywords：

Contrast-enhanced ultrasound; Breast neoplasms; Lymphatic metastasis; Sentinel lymphatic node; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20150090

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the value of ultrasound contrast agents injected subcutaneously for diagnosing sentinel lymph nodes of breast cancer. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library, CNKI, CBM, WanFang Data, and Medalink from their inception to July 2014, to collect diagnostic accuracy studies of ultrasound contrast agents injected subcutaneously for diagnosing sentinel lymph nodes of breast cancer. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using Meta-Disc 1.4 software. Results Eight studies involving 311 sentinel lymph nodes were included. The results of meta-analysis showed that, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under curve (AUC) of SROC were 0.89 (95%CI 0.84 to 0.93), 0.81 (95%CI 0.72 to 0.87), 4.14 (95%CI 2.20 to 7.79), 0.15 (95%CI 0.10 to 0.25), 33.23 (95%CI 11.17 to 98.83), and 0.96 respectively. Conclusion Contrast-enhanced ultrasound has a high value in diagnosis of sentinel lymph nodes of breast cancer. Due to limited quality and quantity of the included studies, more high quality and large-scale studies are needed to verify the above conclusion.

Citation： WANGYan, NaDi-re D·Teliewuhan, MUYan, YAOLan-hui. Value of Ultrasound Contrast Agents Injected Subcutaneously for Diagnosing Sentinel Lymph Nodes of Breast Cancer: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(5): 537-541. doi: 10.7507/1672-2531.20150090 Copy

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2.	鐘麗瑤, 周平, 李瑞珍, 等. 經皮下注射超聲造影劑在乳腺癌前哨淋巴結診斷中的價值. 中華超聲影像學雜志, 2007, 16(9):770-772.
3.	米成嶸, 何雁, 王文. 經皮下注射超聲造影劑在乳腺腫塊前哨淋巴結檢測中的應用價值. 中華超聲影像學雜志, 2010, 19(11):970-973.
4.	張茂春, 顧鵬. 超聲造影判定乳腺癌前哨淋巴結的性質. 中國醫學影像技術, 2012, 28(3):516-519.
5.	孫艷娟, 米成嶸. 經靜脈注射與經皮下注射超聲造影劑檢查乳腺癌前哨淋巴結的比較. 中國超聲醫學雜志, 2012, 28(7):601-604.
6.	于志強, 李志旺, 韋偉, 等. 超聲造影指導乳腺癌前哨淋巴結活檢的價值. 中國老年學雜志, 2013, 33(3):533-535.
7.	Podkrajsek M, Hocevar M. The role of contrast enhanced axillary ultrasonography in early breast cancer patients. Coll Antropol, 2011, 35(1):37.
8.	Ouyang Q, Chen L, Zhao H, et al. Detecting Metastasis of Lymph Nodes and Predicting Aggressiveness in Patients With Breast Carcinomas. J Ultrasound Med, 2010, 29(3):343-352.
9.	Sever A, Jones S, Cox K, et al. Preoperative localization of sentinel lymph nodes using intradermal microbubbles and contrast-enhanced ultrasonography in patients with breast cancer. Br J Surg, 2009, 96(11):1295-1299.
10.	Salvatore S, Quaia E, Bertolotto M, et al. The application of ultrasound contrast agents in the characterization of renal tumors. World J Urol, 2004, 22(5):316-322.
11.	Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary lymph-node dissection in clinically node-negative patients with breast cancer:Overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol, 2010, 11(10):927-933.
12.	Soni NK, Spillane AJ. Experience of sentinel node biopsy alone in early breast cancer without further axillary dissection in patients with negative sentinel node. ANZ J Surg, 2005, 75(5):292-299.
13.	Iannacc C, Di LL, Lepore M, et al. Prognostic and curative value of sentinel node in breast cancer. A377 patients experience, Annital Chir, 2010, 81(2):103-113.
14.	Schmid-Schonbein GW. Mircrolymphatics and lymph flow. Physiol Rev, 1990, 70(4):987-1028.

1. Morrow M, Gradishar W. Breast cancer. BMJ, 2002, 324(7334):410-414.
2. 鐘麗瑤, 周平, 李瑞珍, 等. 經皮下注射超聲造影劑在乳腺癌前哨淋巴結診斷中的價值. 中華超聲影像學雜志, 2007, 16(9):770-772.
3. 米成嶸, 何雁, 王文. 經皮下注射超聲造影劑在乳腺腫塊前哨淋巴結檢測中的應用價值. 中華超聲影像學雜志, 2010, 19(11):970-973.
4. 張茂春, 顧鵬. 超聲造影判定乳腺癌前哨淋巴結的性質. 中國醫學影像技術, 2012, 28(3):516-519.
5. 孫艷娟, 米成嶸. 經靜脈注射與經皮下注射超聲造影劑檢查乳腺癌前哨淋巴結的比較. 中國超聲醫學雜志, 2012, 28(7):601-604.
6. 于志強, 李志旺, 韋偉, 等. 超聲造影指導乳腺癌前哨淋巴結活檢的價值. 中國老年學雜志, 2013, 33(3):533-535.
7. Podkrajsek M, Hocevar M. The role of contrast enhanced axillary ultrasonography in early breast cancer patients. Coll Antropol, 2011, 35(1):37.
8. Ouyang Q, Chen L, Zhao H, et al. Detecting Metastasis of Lymph Nodes and Predicting Aggressiveness in Patients With Breast Carcinomas. J Ultrasound Med, 2010, 29(3):343-352.
9. Sever A, Jones S, Cox K, et al. Preoperative localization of sentinel lymph nodes using intradermal microbubbles and contrast-enhanced ultrasonography in patients with breast cancer. Br J Surg, 2009, 96(11):1295-1299.
10. Salvatore S, Quaia E, Bertolotto M, et al. The application of ultrasound contrast agents in the characterization of renal tumors. World J Urol, 2004, 22(5):316-322.
11. Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary lymph-node dissection in clinically node-negative patients with breast cancer:Overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol, 2010, 11(10):927-933.
12. Soni NK, Spillane AJ. Experience of sentinel node biopsy alone in early breast cancer without further axillary dissection in patients with negative sentinel node. ANZ J Surg, 2005, 75(5):292-299.
13. Iannacc C, Di LL, Lepore M, et al. Prognostic and curative value of sentinel node in breast cancer. A377 patients experience, Annital Chir, 2010, 81(2):103-113.
14. Schmid-Schonbein GW. Mircrolymphatics and lymph flow. Physiol Rev, 1990, 70(4):987-1028.

Chinese Journal of Evidence-Based Medicine

Value of Ultrasound Contrast Agents Injected Subcutaneously for Diagnosing Sentinel Lymph Nodes of Breast Cancer: A Meta-analysis

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