超声联合免疫炎症指标构建列线图预测早期浸润性导管癌淋巴结转移  

Ultrasound Combined with Immunoinflammatory Indexes to Construct Nomogram to Predict Lymph Node Metastasis in Early Invasive Ductal Carcinoma

作　　者：史娜 王爽 马兆丽 李丽 余承芳 朴艺兰 Shi Na;Wang Shuang;Ma Zhaoli;Li Li;Yu Chengfang;Piao Yilan(Department of Ultrasound Medicine,Yanbian University Hospital(Yanbian Hospital),Yanji,Jilin 133000,China)

机构地区：[1]延边大学附属医院(延边医院)超声医学科,吉林省延吉市133000

出　　处：《中国超声医学杂志》2025年第3期265-269,共5页Chinese Journal of Ultrasound in Medicine

基　　金：吉林省教育厅科学技术研究项目(No.JJKH20220548KJ)。

摘　　要：目的 基于超声特征、病理资料、炎症指标构建列线图模型,探讨其预测早期浸润性导管癌(IDC)患者腋窝淋巴结转移(ALNM)的价值。方法 回顾性分析268例经穿刺或术后病理证实为早期IDC患者的超声特征、病理资料及炎症指标,以7∶3比例随机分为训练集(187例)和验证集(81例)。根据有无ALNM进一步分为转移组与无转移组,对两组进行单因素及多因素Logistic回归分析后构建列线图预测模型并验证其临床应用价值。结果 肿块超声特征(边缘不光整、成角、AdlerⅢ级)、病理资料(P53阳性、淋巴管血管侵犯)、炎症指标(中性粒细胞与淋巴细胞比值>2.792)是早期IDC患者ALNM的独立危险因素(P<0.05),以此构建列线图模型。训练集和验证集曲线下面积分别为0.936、0.870,校准曲线与理想曲线较为贴合,其区分度及校准度较高。临床决策曲线显示具有较好的临床价值。结论 根据早期IDC患者原发灶超声特征、病理资料、炎症指标构建的列线图模型可有效预测ALNM。Objective To evaluate the predictive value of nomograms constructed based on ultrasound features,pathologic data and inflammatory markers for axillary lymph node metastasis(ALNM)of early invasive ductal carci-noma(IDC).Methods The ultrasound characteristics,pathological data and inflammation indexes of 268 patients with pathologically confirmed early IDC were retrospectively analyzed.They were randomly divided into a training set(187 cases)and a test set(8l cases)in a 7:3 ratio.According to the presence or absence of ALNM,the patients were further divided into metastasis group and non-metastasis group.The predictive model was constructed after uni-variate and multivariate Logistic regression analysis and its clinical application value was validated.Results The ultra-sound characteristics of the mass(margin irregularity,angulation,Adler grade II),pathological information(P53-positive,lymphovascular invasion),and inflammatory index(neutrophil-to-lymphocyte ratio>2.792)were independ-ent risk factors for ALNM in patients with early-stage IDC(P<0.05),which were used to construct the nomogram.The area under the curves of the training set and test set was 0.936 and 0.870,and the calibration curves fit the ideal curves more closely,and their differentiation and calibration were high.The clinical decision curve had good clinical value.Conclusions The nomogram constructed on the basis of ultrasound characteristics of primary mass,pathologic information,and inflammatory markers in patients with early IDC is effective in predicting ALNM.

关 键 词：乳腺肿瘤 超声检查 腋窝淋巴结 列线图 

分 类 号：R73[医药卫生—肿瘤]