| 华蓓,陈军,耿立娜,张晖,户培华,刘斋,王勇.对比增强能谱乳腺摄影联合病理指标诊断乳腺癌腋窝淋巴结转移[J].中国医学影像技术,2023,39(2):204~209 |
| 对比增强能谱乳腺摄影联合病理指标诊断乳腺癌腋窝淋巴结转移 |
| Contrast enhancement spectral mammography combined with pathological parameters for diagnosing axillary lymph node metastases of breast cancer |
| 投稿时间：2022-08-28 修订日期：2022-12-07 |
| DOI：10.13929/j.issn.1003-3289.2023.02.012 |
| 中文关键词: 乳腺肿瘤 淋巴结转移 乳腺X线摄影 |
| 英文关键词:breast neoplasms lymphatic metastasis mammography |
| 基金项目:河北省医学科学研究重点课题项目（20230897）。 |
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| 中文摘要: |
| 目的 观察对比增强能谱乳腺摄影（CESM）联合病理指标诊断乳腺癌腋窝淋巴结（ALN）转移的价值。方法 纳入215例肿块型乳腺癌，按18 ∶ 7比例随机分为训练集（n=155）和验证集（n=60）；对比训练集内发生与未发生ALN转移者CESM影像学特征及病理资料，行logistic回归分析，筛选发生ALN转移的独立危险因子，构建联合模型，评价其诊断ALN转移的价值。结果 训练集中，伴与不伴ALN转移的乳腺癌之间，所在象限、最大径、形态、边缘毛刺征、腋前肿大淋巴结、乳腺头足（CC）位及内外斜（MLO）病灶相对强化灰度比值（RS%CC、RS%MLO）、组织学类型、脉管侵犯及Ki-67表达差异均有统计学意义（P均<0.05）。最大径、边缘毛刺征、腋前肿大淋巴结、RS%MLO、脉管侵犯及Ki-67表达为乳腺癌ALN转移的独立危险因子（P均<0.05）；以之建立的联合模型诊断训练集和验证集ALN转移的曲线下面积均为0.85。结论 CESM联合病理指标诊断乳腺癌ALN转移效能较佳。 |
| 英文摘要: |
| Objective To explore the value of contrast enhancement spectral mammography (CESM) combined with pathological parameters for diagnosing axillary lymph node (ALN) metastases of breast cancer. Methods Totally 215 patients with mass type breast cancer were enrolled and randomly divided into training set (n=155) and validation set (n=60) at the ratio of 18:7. CESM characteristics and pathological parameters of breast masses with or without ALN metastases in training set were compared, then logistic regression analysis was performed. The independent risk factors of ALN metastases of breast cancer were screened to establish a model, and the value of the model for diagnosing ALN metastases was analyzed. Results In the training set, significant differences of quadrant, maximum diameter, shape, margin spiculation sign, preaxillary enlarged lymph nodes, the relative enhancement rate of lesion over background on cranio caudal (CC, RS%CC) or medial lateral oblique (MLO, RS%MLO) view, histological type, lymphovascular invasion and Ki-67 expression were found between breast masses with or without ALN metastases (all P<0.05). The maximum diameter, margin spiculation sign, preaxillary enlarged lymph nodes, RS%MLO, lymphovascular invasion and Ki-67 expression were all independent risk factors of ALN metastases (all P<0.05). A combined model was established, and the areas under the curves for diagnosing ALN metastases of breast cancer were both 0.85 in training set and validation set. Conclusion CESM combined with pathological parameters were effective for diagnosing ALN metastases of breast cancer. |
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