基于超声造影参数的Logistic回归模型预测浸润性乳腺癌Ki-67表达水平的临床价值  

Clinical value of Logistic regression model based on contrast-enhanced ultrasound parameters in predicting Ki-67 expression level in invasive breast cancer

作　　者：王玉敏 梁丹艳 王芳 李静 孙冉 武雯雯 高慧敏 红华 WANG Yumin;LIANG Danyan;WANG Fang;LI Jing;SUN Ran;WU Wenwen;GAO Huimin;HONG Hua(Department of Ultrasound Medicine,People’s Hospital of Inner Mongolia,Hohhot 010017,China)

机构地区：[1]内蒙古自治区人民医院超声医学科,呼和浩特市010017 [2]内蒙古自治区人民医院质量管理处统计室,呼和浩特市010017 [3]内蒙古科技大学包头医学院

出　　处：《临床超声医学杂志》2023年第11期905-909,共5页Journal of Clinical Ultrasound in Medicine

基　　金：内蒙古自治区科技计划项目(2021GG0125);内蒙古自治区科技计划项目(2020GG0086);内蒙古医科大学科技百万工程联合项目[KD2020KJBW(LH)044]。

摘　　要：目的 探讨基于超声造影参数的Logistic回归模型预测浸润性乳腺癌Ki-67表达水平的临床价值。方法 选取我院经手术病理确诊的浸润性乳腺癌患者66例,根据术后病理组织中Ki-67表达水平分为Ki-67低表达组27例和Ki-67高表达组39例;比较两组病灶常规超声及超声造影参数的差异,包括病灶最大径、血流分级、到达时间(AT)、达峰时间(TTP)、峰值强度(PI)、上升支斜率(AS)、峰值减半时间(DT/2)、平均通过时间(MTT)、曲线下面积(AUC);并将两组比较差异有统计学意义的参数与Ki-67表达水平进行相关性分析。应用多因素Logistic回归分析建立基于超声造影参数预测模型;绘制受试者工作特征(ROC)曲线分析其预测浸润性乳腺癌Ki-67表达水平的诊断效能。结果 与Ki-67低表达组比较,Ki-67高表达组病灶最大径、血流分级Ⅱ~Ⅲ级占比、PI、AS均增大,AT减小,差异均有统计学意义(均P<0.05)。相关性分析显示,AT与Ki-67表达水平呈负相关(r=-0.579,P<0.001),PI、血流分级与Ki-67表达水平均呈正相关(r=0.318、0.549,均P<0.01)。多因素Logistic回归分析显示,AT为预测Ki-67表达水平的独立保护因素(OR=0.392,P<0.05),PI、血流分级为预测Ki-67表达水平的独立危险因素(OR=1.325、17.014,均P<0.05)。构建预测Ki-67表达水平的模型:Logit(P)=1.335-0.937×AT+0.281×PI+2.834×血流分级。ROC曲线分析显示,其预测Ki-67表达水平的曲线下面积为0.936,灵敏度、特异度分别为87.2%、88.9%。结论 基于超声造影参数的Logistic回归模型在预测浸润性乳腺癌Ki-67表达水平中有一定临床价值,可为无创评估Ki-67表达水平提供一定的影像学依据。Objective To investigate the clinical value of Logistic regression model based on contrast-enhanced ultrasound parameters in predicting Ki-67 expression level in invasive breast cancer.Methods Sixty-six patients with pathologically confirmed invasive breast cancer were selected from our hospital.According to the Ki-67 expression level,the patients were divided into low-expression group(27 cases)and high-expression group(39 cases).The differences of two-dimensional characteristics,including maximum diameter,blood flow grading,arrival time(AT),time to peak(TTP),peak intensity(PI),ascending slope(AS),descending time/2(DT/2),mean transit time(MTT)and area under curve(AUC)between the two groups were compared.The correlation between Ki-67 expression level and different indexes were analyzed.Multiple Logistic regression analysis was used to establish the prediction model based on contrast-enhanced ultrasound parameters.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy in predicting Ki-67 expression levels.Results Compared with the low-Ki-67 expression group,the maximum diameter and the proportion of blood flow gradingⅡ~Ⅲ,PI and AS in the high-Ki-67 expression group were significantly increased,while the AT in the high-Ki-67 expression group was significantly decreased,with statistical significance(all P<0.05).Correlation analysis showed that AT was negatively associated with Ki-67 expression level(r=-0.579,P<0.001),while PI and blood flow grading were positively associated with Ki 67 expression level(r=0.318,0.549,both P<0.01).AT was an independent protective factor for predicting Ki-67 expression level(OR=0.392,P<0.05),PI and blood flow grading were independent risk factors for predicting Ki-67 expression level(OR=1.325,17.014,both P<0.05).A model for predicting Ki-67 expression level was constructed:Logit(P)=1.335-0.937×AT+0.281×PI+2.834×blood flow grading.ROC curve analysis showed that the area under the curve for predicting Ki-67 expression level was 0.936,with sensitivi

关 键 词：超声检查 造影剂 时间-强度曲线 乳腺癌 浸润性 Ki-67表达水平 

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]