| 陈桂芳,张晴,朱鹏飞,冒玉香,王珏,陈秋怡,何英.超声联合实验室指标列线图预测cT1N0期乳腺浸润性导管癌腋窝淋巴结转移[J].中国医学影像技术,2025,41(4):611~615 |
| 超声联合实验室指标列线图预测cT1N0期乳腺浸润性导管癌腋窝淋巴结转移 |
| Nomogram of ultrasound combined with laboratory indexes for predicting axillary lymph node metastasis of cT1N0 stage breast invasive ductal carcinoma |
| 投稿时间：2024-08-10 修订日期：2025-03-24 |
| DOI：10.13929/j.issn.1003-3289.2025.04.022 |
| 中文关键词: 乳腺肿瘤 淋巴转移 超声检查 列线图 |
| 英文关键词:breast neoplasms lymphatic metastasis ultrasonography nomograms |
| 基金项目:南通市卫生健康委科研课题(MS2022052)。 |
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| 中文摘要: |
| 目的 观察超声联合实验室指标列线图预测cT1N0期乳腺浸润性导管癌(IDC)腋窝淋巴结转移(ALNM)的价值。方法 回顾性收集77例经病理证实的单发cT1N0期乳腺IDC,其中23例ALNM、54例无ALNM。采用单因素分析及多因素二元logistic回归分析临床、实验室指标及病灶超声表现,筛选cT1N0期乳腺IDC ALNM的独立预测因素,分别以之建立实验室指标模型、超声模型及其联合模型并绘制联合模型列线图。采用受试者工作特征(ROC)曲线评估各模型预测效能,以校准曲线分析联合模型预测结果与实际结果的一致性,并采用决策曲线分析(DCA)观察各模型临床价值。结果 血清糖类抗原153(CA153)(OR=1.132)、血小板与淋巴细胞比(PLR)(OR=1.020)及超声显示病灶后方回声衰减(OR=8.789)均为cT1N0期乳腺IDC ALNM的独立预测因素(P均＜0.05),以之构建的实验室指标模型(CA153联合PLR)、超声模型及联合模型预测cT1N0期乳腺IDC ALNM的曲线下面积(AUC)分别为0.757、0.616及0.836。联合模型预测结果与实际结果的一致性良好;阈值＞0.15时,联合模型的净收益高于其他模型。结论 超声联合实验室指标列线图能有效预测cT1N0期乳腺IDC ALNM。 |
| 英文摘要: |
| Objective To observe the value of nomogram of ultrasound combined with laboratory indexes for predicting axillary lymph node metastasis (ALNM) of stage cT1N0 breast invasive ductal carcinoma (IDC). Methods A total of 77 cases with pathologically diagnosed stage cT1N0 single breast IDC were retrospectively collected, including 23 cases with and 54 cases without ALNM. Univariate and multivariate binary logistic regression analysis were used to analyze clinical data, laboratory indicators and ultrasonic manifestations, then the independent predictors of ALNM of stage cT1N0 breast IDC were screened to establish laboratory indexes model, ultrasound model and combined model, respectively, and nomogram of the combined model was drawn. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive efficacy of each model. The consistency of results of combined model and actual results was analyzed using calibration curve. Decision curve analysis (DCA) was used to explore the clinical value of each model. Results Serum carbohydrate antigen 153 (CA153) (OR=1.132), platelet-to-lymphocyte ratio (PLR) (OR=1.020) and echo attenuation behind the lesion on ultrasound (OR=8.789) were all independent predictors of ALNM in stage cT1N0 breast IDC (all P＜0.05), and the area under the curve (AUC) of laboratory indexes model, ultrasound model and combined model for predicting ALNM of stage cT1N0 breast IDC was 0.757, 0.616 and 0.836, respectively. The consistency of the predicted results of combined model and actual results was good. When the threshold was higher than 0.15, the net benefit of combined model was higher than that of the other 2 models. Conclusion Nomogram of ultrasound combined with laboratory indexes could effectively predict ALNM of stage cT1N0 breast IDC. |
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