中文摘要：

目的探讨造影增强能量多普勒超声对腋淋巴结阴性乳腺癌患者血管生成及预后评价的价值，为腋淋巴结阴性乳腺癌寻求判断预后的指标。方法对60例随访资料完整的腋淋巴结阴性乳腺癌患者，术前采用造影增强能量多普勒显像检测肿瘤内血流信号，并通过图像分析技术定量测定肿瘤内血管阳性反应总面积，采用免疫组织化学技术检测肿瘤内的微血管密度，分析造影前后肿瘤内血管阳性反应总面积与肿瘤内微血管密度的关系，单因素和多因素方法分析造影后肿瘤内血管阳性反应总面积和微血管密度与腋淋巴结阴性乳腺癌预后的关系。结果所有病例造影增强前能量多普勒检测血管阳性反应总面积与微血管密度无相关性（r=0．25，P〉0．05），造影增强后血管阳性反应总面积与微血管密度呈正相关（r=0．65，P〈0．05）。造影增强后血管阳性反应总面积、微血管密度均与一般临床病理因素无关，与组织学分级和复发转移密切相关，术后复发转移组造影增强后血管阳性反应总面积、肿瘤内微血管密度均显著高于无瘤生存组。高血管阳性反应总面积组及高微血管密度组总生存率和无瘤生存率低于低血管阳性反应总面积组和低微血管密度组（P〈0．05）。结论造影增强能量多普勒超声对腋淋巴结阴性乳腺癌血管生成活性的检测可作为有价值的预后预测指标，高血管生成活性者预后差，术后行辅助治疗的同时应加以抗血管生成治疗。

英文摘要：

Objective To determine the value of contrast ultrasound on evaluating tumor angiogenic activity and its prognostic value in axillary-node-negative breast carcinoma （ANNBC）. Methods Power doppler imaging （PDI）was used to observe intratumoral vascularization before and post contrast agents injection. Intratumoral blood flow signals were measured and intratumoral vessel positive total areas （VPTA） were analyzed with computer-assisted quantative assessment. Sections of malignant tumors were analyzed for the intratumoral microvessel density （MVD） by immunohistochemistry using monoclonal antibody to factor H-related antigen. The relationships within VPTA, MVD and prognosis were the main outcome measures. Results There was no significant correlation between VPTA and MVD before contrast agents used while there was a positive correlation between them after that. However, VPTA and MVD had significant correlation with histology grade and tumor recurrence and metastasis while had no correlation with the general clinic pathologic factors. VPTA and MVD were significantly higher in postoperative cases with recurrence or metastasis than those in cases with tumor-free. Total survival rate and tumor-free survival rate of high-VPTA or high-MVD group were significantly lower than those of Iow-VPTA or Iow-MVD group. Conclusions The value of VPTA by contrast enhanced PDI was a beneficial prognostic indicator. High VPTA in ANNBC patients may has worse prognosis and antiangiogenic therapy is strongly suggested on them.