浸润性乳腺癌淋巴管侵犯的诺模图预测模型的建立  

Nomogram method to predict lymphatic invasion of invasive breast cancer

作　　者：韩云 张东友[1] HAN Yun;ZHANG Dongyou(Department of Radiology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]湖北省武汉市第一医院放射科,湖北武汉430022

出　　处：《中国中西医结合影像学杂志》2020年第4期369-373,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:建立能够可靠预测浸润性乳腺癌(IBC)淋巴管侵犯(LVI)的诺模图。方法 :对61例IBC患者术前MRI及临床病理学资料进行回顾性分析。以术后病理为金标准,将患者分为LVI阳性与LVI阴性。使用Logistic回归分析LVI阳性的独立危险因素,依据多因素结果建立诺模图预测模型。使用一致性系数(C-index)和校准曲线评估模型的校准度,通过诺模图依赖ROC曲线评估模型的区分度。结果:61例中,LVI阳性率36.07%(22/61);转移淋巴结(OR=4.601,P=0.042)、ADC值(OR=0.006,P=0.038)、瘤周水肿(OR=5.496,P=0.031)是IBC患者LVI阳性的独立危险因素;诺模图预测模型显示:ADC值是预测IBC患者LVI的最大贡献因子(100分),其余依次为瘤周水肿(95.0分)及转移淋巴结(37.5分),该诺模图的C-index为0.909;ROC曲线的AUC为0.909,敏感度、特异度分别为81.80%、87.20%。结论:转移淋巴结、ADC值及瘤周水肿是IBC发生LVI的独立危险因素,以此构建诺模图能为IBC患者LVI阳性提供可靠的预测依据。Objective:To establish a nomogram that can reliably predict lymphatic invasion(LVI) in invasive breast cancer(IBC).Methods:The preoperative MRI and clinicopathological data of IBC patients admitted to our hospital were retrospectively analyzed.The patients with IBC were divided into LVI positive and LVI negative according to the gold standard of postoperative pathology.Logistic regression was used to analyze the independent risk factors of LVI positive in IBC patients.Nomogram was established to predict and validate the risk factors.The consistency index(C-index) and calibration curve were used to evaluate the calibration degree of the model,and the discrimination degree of the model was evaluated by the nomogram relying on ROC curve.Results:The positive rate of LVI was 36.07%(22/61) in 61 IBC patients.Metastatic lymph nodes(OR=4.601,P=0.042),ADC value(OR=0.006,P=0.038),peritumoral edema(OR=5.496,P=0.031) were independent risk factors for LVI positive in IBC patients.Nomogram graph showed that ADC value was the largest contributing factor(100 points) in predicting LVI in IBC patients,and the others were peritumoral edema(95.0 points) and metastatic lymph nodes(37.5 points).The C-index of the nomogram was 0.909;the area under ROC curve was 0.909,the sensitivity and specificity were 81.80% and 87.20% respectively.Conclusion:Nomogram can provide reliable predictive effect for LVI positive patients with IBC.

关 键 词：乳腺肿瘤 淋巴管侵犯 诺模图 

分 类 号：R737.9[医药卫生—肿瘤]