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基于多模态超声定量参数构建乳腺癌新辅助化疗后腋窝淋巴结病理完全缓解的预测模型 |
葛红军,陆琳,张子宁,周菊英,朱莉华 |
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(江阴市中医院/南京中医药大学江阴附属医院超声医学科) |
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摘要: |
目的:基于多模态超声定量参数构建预测模型,分析预测模型对乳腺癌新辅助化疗(NAC)后腋窝淋巴结病理完全缓解(pCR)的预测价值。方法:选取2020年1月~2022年12月在我院行NAC的乳腺癌患者150例,按照腋窝淋巴结是否pCR分为pCR组43例和非pCR组107例,分析乳腺癌患者NAC后腋窝pCR的危险因素,构建乳腺癌患者NAC后腋窝pCR的的预测模型,采用Hosmer-Lemeshow检验模型的拟合度,采用受试者工作特征(ROC)曲线分析预测模型的价值。结果:两组年龄、病理类型、临床分期、cT分期、腋窝淋巴结转移率、乳腺癌家族史率、Ki67指数、绝经率、新辅助化疗方案比较,均无统计学意义(P﹥0.05),两组分子分型、淋巴结大小比较,均有统计学意义(P<0.05)。pCR组RI、PSV、PI、最长径变化率明显高于非pCR组(P<0.05),pCR组弹性评分明显低于非pCR组(P<0.05)。经多因素二元Logistic分析,高RI是乳腺癌患者NAC后腋窝pCR的危险因素(P<0.05),高弹性评分是乳腺癌患者NAC后腋窝pCR的保护因素(P<0.05)。Hosmer-Lemeshow拟合度检验显示,χ2=6.966,P=0.540,模型拟合优度较好。受试者工作特征(ROC)曲线分析显示,乳腺癌患者NAC后腋窝pCR的风险模型的AUC为0.858,约登指数为0.716,敏感度、特异度分别为74.42%、97.206%,实际应用的准确性为90.67%。结论:本研究基于多模态超声定量参数构建的乳腺癌患者NAC后腋窝pCR的预测模型效果较好。 |
关键词: 多模态超声定量参数 乳腺癌 新辅助化疗 腋窝淋巴结病理完全缓解 预测模型 |
DOI: |
投稿时间:2023-05-16修订日期:2023-09-13 |
基金项目:项目名称:回春方通过下调转录因子FOXM1经由Wnt/β-catenin通路抑制三阴性乳腺癌的增值、转移和EMT项目编号:Z2022203 |
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Based on the quantitative parameters of multimodal ultrasound, a prediction model of axillary lymph node pathological complete remission after neoadjuvant chemotherapy for breast cancer was established |
gehongjun,lulin,zhangzining,zhoujuying,zhulihua |
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Abstract: |
Objective:Based on the quantitative parameters of multimodal ultrasound, a prediction model was established, and the predictive value of the prediction model for axillary lymph node pathological complete remission (pCR) after neoadjuvant chemotherapy (NAC) for breast cancer was analyzed.Methods:150 breast cancer patients who underwent NAC in our hospital from January, 2020 to December, 2022 were divided into pCR group (43 cases) and non-pCR group (107 cases) according to whether axillary lymph nodes were pCR. The risk factors of axillary pCR in breast cancer patients after NAC were analyzed, and the prediction model of axillary pCR in breast cancer patients after NAC was constructed. Hosmer-Lemeshow was used to test the fitting degree of the model, and the value of the prediction model was analyzed by the receiver"s working characteristics (ROC) curve.Result:There was no significant difference in age, pathological type, clinical stage, cT stage, axillary lymph node metastasis rate, family history rate of breast cancer, Ki67 index, menopause rate and neoadjuvant chemotherapy scheme between the two groups (P<0.05), but there was significant difference in molecular classification and lymph node size between the two groups (P< 0.05). The change rate of RI, PSV, PI and longest diameter in pCR group was significantly higher than that in non-pCR group (P<0.05), and the elasticity score in pCR group was significantly lower than that in non-pCR group (P<0.05). Multivariate binary Logistic analysis showed that high RI was a risk factor for axillary pCR in breast cancer patients after NAC (P<0.05), and high elasticity score was a protective factor for axillary pCR in breast cancer patients after NAC (P<0.05). Hosmer-Lemeshow test shows that χ2=6.966, P=0.540, and the model has a good goodness of fit. The curve analysis of receiver"s operating characteristics (ROC) shows that the AUC of the risk model of axillary pCR for breast cancer patients after NAC is 0.858, the Jordan index is 0.716, the sensitivity and specificity are 74.42% and 97.206% respectively, and the accuracy of practical application is 90.67%.Conclusion:In this study, the prediction model of axillary pCR for breast cancer patients after NAC based on multimodal ultrasound quantitative parameters is effective. |
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