超声特征联合免疫组化构建列线图预测早期乳腺癌前哨淋巴结转移  

Ultrasound Combined with Immunohistochemistry to Construct a Nomogram to Predict Sentinel Lymph Node Metastasis in Early-stage Breast Cancer

作　　者：孙芳[1] 杨智[1] 许永波[1] 刘群[1] 王园园 崔广和[1] Sun Fang;Yang Zhi;Xu Yongbo;Liu Qun;Wang Yuanyuan;Cui Guanghe(Department of Ultrasound,Binzhou Medical University Hospital,Shandong 256603,China)

机构地区：[1]滨州医学院附属医院超声医学科,山东省滨州市256603

出　　处：《中国超声医学杂志》2022年第2期146-150,共5页Chinese Journal of Ultrasound in Medicine

基　　金：山东省医药卫生科技发展计划项目(No.202009020663)。

摘　　要：目的探讨联合原发病灶的超声特征及免疫组化指标构建列线图预测早期乳腺癌前哨淋巴结转移(SLNM)的临床意义。方法回顾性纳入577例早期乳腺癌患者作为训练组及内部验证组,纳入183例早期乳腺癌患者作为外部验证组。分析原发灶超声特征及免疫组化特征,筛选预测早期乳腺癌SLNM的独立预测变量,基于上述独立预测变量绘制列线图,并进行内部验证和外部验证。结果病灶大小、位置、边缘及HER-2为SLNM的独立预测变量。基于上述四个变量绘制列线图及ROC曲线,AUC为0.856,根据约登指数确定截断值为0.76(对应总分约208分)。内部验证和外部验证均显示列线图具有较高的预测能力。结论基于原发病灶的超声特征及免疫组化指标构建列线图术前评估早期乳腺癌SLNM的状态在一定程度上可指导早期乳腺癌患者的个体化治疗。Objective To evaluate the clinical value of ultrasound and immunohistochemical characteristics of the primary lesion to predict sentinel lymph node metastasis(SLNM)in early-stage breast cancer.Methods 577 patients with early-stage breast cancer were enrolled as the training group and internal verification cohort retrospectively.183 patients with early-stage breast cancer were enrolled as the external verification cohort.Conventional ultrasound and immunohistochemical examinations were performed,and the independent risk factors of SLNM were screened.Based on the above independent predictive variables,a nomogram was drawn for internal verification and external verification.Results Lesion size,location,margin and HER-2 were independent predictors of SLNM.Based on the above four variables the nomogram and ROC curve were drawn.AUC was 0.856 and a cutoff value was 0.76(corresponding to a total score of about 208 points).Both internal and external verification showed that the nomogram had high predictive ability.Conclusions The nomogram based on the ultrasound and immunohistochemical characteristics of the primary lesion to assess the status of SLNM in early breast cancer before surgery can guide individualized treatment to a certain extent.

关 键 词：早期乳腺癌 前哨淋巴结 列线图 免疫组化 超声 转移 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]