基于多模态超声参数、临床病理特征的乳腺癌腋窝淋巴结转移预测模型构建与评价  

Construction and Evaluation of Predictive Model for Axillary Lymph Node Metastasis of Breast Cancer Based on Multimodal Ultrasound Parameters and Clinicopathological Features

作　　者：吴莉 邓丽贞 蒋进 肖琳[2] 王月爱[3] WU Li;DENG Li-zhen;JIANG Jin;XIAO Lin;WANG Yue-ai(The First Clinical College of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha,Hunan,410007,China;Department of Functional Medicine,The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,410000,China;Department of Ultrasound,The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,410007,China)

机构地区：[1]湖南中医药大学第一中医临床学院,湖南长沙410007 [2]湖南中医药大学第二附属医院功能科,湖南长沙410000 [3]湖南中医药大学第一附属医院超声科,湖南长沙410007

出　　处：《现代生物医学进展》2024年第22期4259-4261,4301,共4页Progress in Modern Biomedicine

基　　金：湖南省卫生健康委科研计划项目(D202309027332)。

摘　　要：目的:探讨基于多模态超声参数、临床病理特征构建的列线图(Nomogram)预测模型对乳腺癌(BC)发生腋窝淋巴结转移(ALNM)的预测价值。方法:根据251例BC患者是否发生ALNM将其分为ALNM组(102例)和非ALNM组(149例)。比较两组多模态超声参数及临床病理特征。采用多因素Logistic回归分析BC患者发生ALNM的影响因素,并Nomogram预测模型。结果:ALNM组淋巴结短径、淋巴结皮质厚度、淋巴结短径/长径、弹性应变率比值(SR)、弹性模量最大值(Emax)、弹性模量最小值(Emin)、弹性模量平均值(Emean)、标准差(SD)、彩色多普勒血流显像(CDFI)血流分型Ⅲ型/Ⅳ型比例、淋巴血管浸润比例、浸润性癌比例、组织学分级Ⅲ级比例均高于非ALNM组(P<0.05)。合并CDFI血流分型Ⅲ型/Ⅳ型、发生淋巴血管浸润、组织学分级Ⅲ级、较高的淋巴结短径/长径、SR、Emax是BC患者发生ALNM的危险因素(P<0.05)。Nomogram预测模型的预测曲线与理想曲线贴合度良好,一致性指数为0.897。结论:基于多模态超声参数、临床病理特征构建的Nomogram模型在预测BC患者发生ALNM风险方面具有较高的价值。Objective:To explore the predictive value of nomogram(Nomogram)prediction model based on multimodal ultrasound parameters and clinicopathological features for axillary lymph node metastasis(ALNM)of breast cancer(BC).Methods:251 BC patients were divided into ALNM group(102 cases)and Non-ALNM group(149 cases)according to whether ALNM occurred in BC patients.The multimodal ultrasound parameters and clinicopathological features were compared in two groups.The influencing factors of ALNM in BC patients were analyzed by multivariate Logistic regression,and the Nomogram prediction model was constructed.Results:The lymph node short diameter,lymph node cortical thickness,lymph node short diameter/long diameter,elastic strain rate ratio(SR),maximum elastic modulus(Emax),minimum elastic modulus(Emin),mean elastic modulus(Emean),standard deviation(SD),color Doppler flow imaging(CDFI)blood flow classification Ⅲ/Ⅳ type ratio of lymph nodes,lymphatic vascular invasion proportion,invasive carcinoma proportion and histological grade Ⅲ proportion in ALNM group were higher than those in Non-ALNM group(P<0.05).Combined with CDFI blood flow classification Ⅲ/Ⅳ type,lymphatic vascular invasion,histological grade Ⅲ,higher lymph node short diameter/long diameter,SR and Emax were risk factors for ALNM in BC patients(P<0.05).The prediction curve of the Nomogram prediction model was in good agreement with the ideal curve,and the consistency index was 0.897.Conclusion:The Nomogram model based on multimodal ultrasound parameters and clinicopathological features has a high value in predicting the risk of ALNM in BC patients.

关 键 词：乳腺癌 腋窝淋巴结转移 多模态超声参数 病理特征 Nomogram预测模型 

分 类 号：R737.9[医药卫生—肿瘤]