| 章 晋,徐 栋,周玲燕,等.超声结合临床特征基于166例乳腺癌新辅助化疗后腋窝淋巴结评估中的预测价值分析[J].肿瘤学杂志,2023,29(3):203-207. |
| 超声结合临床特征基于166例乳腺癌新辅助化疗后腋窝淋巴结评估中的预测价值分析 |
| Predictive Value of Ultrasound Combined with Clinical Features in the Evaluation of Axillary Lymph Nodes After Neoadjuvant Chemotherapy Based on 166 Cases of Breast Cancer Patients |
| 投稿时间：2023-02-17 |
| DOI：10.11735/j.issn.1671-170X.2023.03.B006 |
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| 中文关键词: 乳腺癌 新辅助化疗 腋窝淋巴结 超声 |
| 英文关键词:breast cancer neoadjuvant chemotherapy axillary lymph nodes ultrasound |
| 基金项目:浙江省卫生健康科技计划（2022KY669，2022KY661， 2022KY641） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨超声结合临床特征在乳腺癌新辅助化疗（neoadjuvant chemotherapy，NAC）后腋窝淋巴结状态的预测价值。［方法］ 回顾性总结2020年6月至2021年10月浙江省肿瘤医院166例初诊乳腺癌且有腋窝淋巴结转移病例，使用Logistic回归模型对临床病理及超声特征与NAC后腋窝淋巴结病理完全缓解(pathological complete response，pCR)的关系进行单因素与多因素分析，建立预测模型，绘制受试者工作特征（receiver operating characteristic，ROC）曲线并得出曲线下面积（area under curve，AUC）。［结果］ 166例乳腺癌患者中，61例经NAC后实现腋窝淋巴结pCR，单因素与多因素分析发现NAC后腋窝淋巴结纵横比值＞2、淋巴结皮质厚度≤3 mm，乳腺癌分子分型为三阴性型与HER2阳性型、乳腺癌原发灶临床疗效达完全缓解和腋窝淋巴结pCR显著相关(P＜0.05)。与单独使用临床病理或超声特征的预测模型相比，超声结合临床病理特征预测模型具有良好的识别性能（AUC为0.88，灵敏度为78.7％，特异度为81.0％）。［结论］ 超声结合临床病理特征对腋窝淋巴结pCR具有较好预测价值，可为临床选择适合的手术方式，减少腋窝淋巴结清扫提供参考。 |
| 英文摘要: |
| Abstract：［Objective］ To analyze the predictive value of ultrasound combined with clinical features for the axillary lymph node status after neoadjuvant chemotherapy(NAC) for breast cancer. ［Methods］ From June 2020 to October 2021， the clinicopathological data and ultrasound imaging features of 166 cases that newly diagnosed as breast cancer with axillary lymph node metastasis in Zhejiang Cancer Hospital were analyzed retrospectively. Logistic regression model was used to analyze the relationship between clinicopathological and ultrasound characteristics and the pathological complete response(pCR) of axillary lymph nodes after NAC for univariate and multivariate analysis. The prediction model was built， the receiver operating characteristic(ROC) curve was draw and the area under curve(AUC) was obtained.［Results］ Among the 166 cases of breast cancer， 61 cases achieved pCR of axillary lymph nodes after NAC， and multivariate regression analysis showed that the axillary lymph node aspect ratio >2， the cortical thickness ≤ 3 mm， the triple negative and the HER2 positive type， and the clinical efficacy of breast primary lesions leading to complete response were significantly associated with axillary lymph node pCR(P<0.05). Compared with the prediction models with clinicopathological or ultrasound features alone， ultrasound combined with clinicopathological data prediction model had better identification performance(AUC was 0.88， sensitivity was 78.7%， specificity was 81.0%). ［Conclusion］ Ultrasound combined with clinical features has prediction value of axillary lymph node pCR， which can provide a reference for reducing axillary lymph node dissection. |
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