早期乳腺癌非前哨淋巴结转移的预测模型构建  

Construction of predictive model for non-sentinel lymph node metastasis in early breast cancer

作　　者：赵杰 王辉[1] 韩志敏[1] 马忠丽[1] Zhao Jie;Wang Hui;Han Zhimin;Ma Zhongli(Department of Thyroid and Breast Surgery,Sanmenxia Central Hospital,Sanmenxia 472000,China)

机构地区：[1]三门峡市中心医院甲乳外科,三门峡472000

出　　处：《中国实用医刊》2022年第12期48-52,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨早期乳腺癌非前哨淋巴结(NSLN)转移的预测模型构建方法,以便为临床诊治早期乳腺癌NSLN转移提供依据。方法纳入2017年1月至2022年1月于三门峡市中心医院经前哨淋巴结活检(SLNB)证实为前哨淋巴结(SLN)阳性的早期乳腺癌患者120例。患者均行腋窝淋巴结清扫术(ALND),根据术后病理结果分为NSLN转移阳性组与NSLN转移阴性组,比较两组病理特征(单因素分析),并对统计学差异显著的病理特征进一步实施多因素回归分析,按照多因素Logistic回归分析建立NSLN转移风险预测模型。结果120例早期乳腺癌,经术后病理证实NSLN转移阳性45例(纳入NSLN转移阳性组),NSLN转移阴性75例(纳入NSLN转移阴性组)。单因素分析结果显示,两组肿瘤长径、肿瘤位置、淋巴管侵犯、SLN转移灶长径、SLN阳性率比较差异均有统计学意义(P均<0.05);多因素回归分析结果显示,早期乳腺癌患者NSLN转移的独立危险因素为肿瘤长径、淋巴管侵犯及SLN阳性率(OR=2.103、5.203、5.671,P均<0.05);早期乳腺癌NSLN转移预测模型计算出的曲线下面积为0.796(95%CI:0.651~0.938)。结论早期乳腺癌NSLN转移风险因素主要为肿瘤长径、淋巴管侵犯及SLN阳性率,根据这些因素构建早期乳腺癌NSLN转移预测模型对NSLN转移有较好的预测价值,术前可辅助医师进行诊断,从而选择更合理的手术方案,提高预后。Objective To investigate the prediction model construction method of non-sentinel lymph node(NSLN)metastasis in early breast cancer,so as to provide a basis for clinical diagnosis and treatment of early NSLN metastasis.Methods One hundred and twenty patients with early-stage breast cancer and SLN positive diagnosed by sentinel lymph node biopsy(SLNB)in Sanmenxia Central Hospital from January 2017 to January 2022 were included.All patients underwent axillary lymph node dissection(ALND),and they were divided into NSLN metastasis positive group and NSLN metastasis negative group according to the postoperative pathological results.The pathological features of the two groups were compared(by univariate analysis),and the statistically significant pathological characteristics were further analyzed by multivariate regression analysis.According to the multivariate Logistic regression analysis,the risk prediction model of NSLN metastasis was established.Results Among the 120 patients with early-stage breast cancer,45 patients with positive NSLN metastasis(included in the NSLN metastasis positive group)and 75 patients with negative NSLN metastasis(included in the NSLN metastasis negative group)were confirmed by postoperative pathology.Univariate analysis showed that there were significant differences in tumor major diameter,tumor location,lymphatic invasion,SLN metastasis major diameter and SLN positive rate between the two groups(all P<0.05).Multivariate regression analysis showed that the independent risk factors for NSLN metastasis in early breast cancer patients included tumor major diameter,lymphatic invasion and SLN positive rate(OR=2.103,5.203,5.671;all P<0.05).The area under the curve calculated by NSLN metastasis prediction model of early breast cancer was 0.796(95%CI:0.651-0.938).Conclusions The risk factors for NSLN metastasis in early breast cancer mainly include tumor major diameter,lymphatic invasion,and positive rate of SLN.According to these factors,building a prediction model for early breast cancer NSLN me

关 键 词：乳腺癌 非前哨淋巴结 淋巴结转移 预测模型 病理特征 

分 类 号：R737.9[医药卫生—肿瘤]