免疫炎症指标联合超声征象对早期乳腺癌腋窝淋巴结转移的临床预测价值  

Clinical prediction value of immunoinflammatory indicators combined with ultrasound signs in axillary lymph node metastasis of early breast cancer

作　　者：张欣华 豆小文 彭绵[2] 张秀明 Zhang Xinhua;Dou Xiaowen;Peng Mian;Zhang Xiuming(School of Medicine,Anhui University of Science and Technology,Huainan,Anhui 232000,China;People's Hospital of Luohu District,Shenzhen,Guangdong 518001,China;Shenzhen Hospital,the University of Hong Kong,Shenzhen,Guangdong 518058,China)

机构地区：[1]安徽理工大学医学院,安徽淮南232000 [2]深圳市罗湖区人民医院,广东深圳518001 [3]香港大学深圳医院,广东深圳518058

出　　处：《齐齐哈尔医学院学报》2024年第23期2219-2225,共7页Journal of Qiqihar Medical University

基　　金：深圳市科技计划(JCYJ20230807142815034)。

摘　　要：目的 探讨免疫炎症指标联合超声征象对早期乳腺癌腋窝淋巴结转移的临床预测价值。方法 选取2021年1月-2024年1月深圳市罗湖区人民医院收治的205例早期浸润性乳腺癌患者作为研究对象,按术后病理结果分为腋窝淋巴结转移组(82例)和腋窝淋巴结非转移组(123例)两组。收集两组患者的临床病例资料,分析炎症指标联合超声征象与腋窝淋巴结转移的关系,通过绘制ROC曲线评估各单一指标及联合指标预测腋窝淋巴结转移的临床诊断价值。结果 多因素Logistic回归分析显示,NLR(OR=2.59)、肿瘤大小(OR=14.49)和边缘(OR=4.37)是腋窝淋巴结转移的独立危险因素(P<0.05),NLR、肿瘤大小和边缘的ROC曲线下面积分别为0.585、0.801和0.61,而联合指标(NLR、肿瘤大小、边缘)预测ALNM的曲线下面积为0.843,均优于单一指标,特异度和灵敏度分别为0.87、0.744(P<0.05)。结论 NLR、肿瘤大小和边缘是乳腺癌腋窝淋巴结转移的独立预测因素,超声联合炎症相关免疫炎症指标可以提高单一指标预测腋窝淋巴结转移的准确性,为辅助临床实施个性化治疗提供参考依据。Objective To explore the clinical predictive value of immunoinflammatory markers combined with ultrasonographic features for axillary lymph node metastasis in early-stage invasive breast cancer.Methods A total of 205 patients with early-stage invasive breast cancer,who were treated in the People's Hospital of Luohu District in Shenzhen from January 2021 to January 2024,were selected as study subjects.Based on postoperative pathological results,these patients were divided into two groups:an axillary lymph node metastasis group(82 patients)and a non-metastasis group(123 patients).Clinical data were collected from both groups of patients to analyze the relationship between inflammatory markers combined with ultrasound features and axillary lymph node metastasis.The clinical diagnostic value of each individual marker and the combined markers for predicting axillary lymph node metastasis was assessed by drawing ROC curves.Results Multifactorial logistic regression analysis revealed that the neutrophil-to-lymphocyte ratio(NLR)(OR=2.59),tumor size(OR=14.49),and margins(OR=4.37)are independent risk factors for axillary lymph node metastasis(P<0.05).The area under the ROC curve(AUC)for NLR,tumor size,and margin individually were 0.585,0.801,and 0.610,respectively.However,the combined index of NLR,tumor size,and margin predicting ALNM showed an AUC of 0.843,which was superior to any single indicator.The specificity and sensitivity of the combined indexes were 0.87 and 0.744,respectively,with statistical significance(P<0.05).Conclusions Neutrophil-to-lymphocyte ratio(NLR),tumor size,and margins are independent predictive factors for axillary lymph node(ALN)metastasis in breast cancer.Combined ultrasound with inflammation-related immunoinflammatory markers enhances the accuracy of single-marker predictions for axillary lymph node metastasis.This combined approach provides a valuable reference for assisting clinical implementation of personalized treatment strategies.

关 键 词：免疫炎症指标 超声征象 乳腺癌 腋窝淋巴结转移 临床预测价值 

分 类 号：R445[医药卫生—影像医学与核医学]