| 陈瑞福,陈隽鹏,裴晓华,等.乳腺癌腋窝淋巴结转移风险预测模型构建[J].肿瘤学杂志,2025,31(1):43-50. |
| 乳腺癌腋窝淋巴结转移风险预测模型构建 |
| Development of a Nomogram Model for Predicting Risk of Axillary Lymph Node Metastasis in Breast Cancer Patient |
| 投稿时间：2024-07-17 |
| DOI：10.11735/j.issn.1671-170X.2025.01.B007 |
|
 |
| 中文关键词: 乳腺肿瘤 腋窝淋巴结转移 诊治延迟 脉管癌栓 Nomogram模型 |
| 英文关键词:breast neoplasms axillary lymph node metastasis delayed diagnosis and treatment vascular cancer thrombus Nomogram model |
| 基金项目:厦门市医疗卫生指导性项目（3502Z20224ZD1178）；北京中医药大学2022年度校级课题（2022-BUCMXJKY-044） |
|
| 摘要点击次数: 171 |
| 全文下载次数: 36 |
| 中文摘要: |
| 摘 要：［目的］ 探讨乳腺癌腋窝淋巴结转移的影响因素，构建并验证预测腋窝淋巴结转移风险的Nomogram预测模型。［方法］ 前瞻性收集2019—2021年在厦门市中医院手术治疗的130例乳腺癌患者的临床病理资料，进一步检测癌组织的微血管密度、微淋巴管密度，根据术后腋窝淋巴结状态分为无转移组67例和转移组63例，对临床、超声、钼靶及病理学等参数进行单因素及多因素分析。应用R语言软件构建预测腋窝淋巴结转移风险的Nomogram模型，采用受试者工作特征（receiver operating characteristic，ROC）曲线对模型进行验证。［结果］ 诊治延迟患者57例（43.85%）。单因素分析显示诊治延迟、肿瘤位于外侧、术前可疑腋窝淋巴结、肿瘤＞2 cm、雌激素受体阳性、脉管癌栓是腋窝淋巴结转移的危险因素。多因素分析结果显示，诊治延迟（OR=5.24，95%CI：1.68~16.34）、术前可疑腋窝淋巴结（OR=11.83，95%CI：3.22~43.42）、雌激素受体阳性（OR=9.30，95%CI：2.22~39.04）以及脉管癌栓（OR=6.93，95%CI：2.29~20.96）是腋窝淋巴结转移的独立危险因素。这4个因素被纳入构建Nomogram预测模型。内部验证评价该模型的ROC曲线下面积值为0.84（95%CI：0.67~1.00）。［结论］ 诊治延迟、术前可疑腋窝淋巴结、雌激素受体阳性及脉管癌栓是乳腺癌腋窝淋巴结转移的独立危险因素，由此构建的Nomogram预测模型具有较高的准确率，在临床上用于术前预测腋窝淋巴结转移发生风险具有一定的价值。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the risk factors of axillary lymph node metastasis in breast cancer patients， and to develop a prediction nomogram model. ［Methods］ The clinicopathological data of 130 breast cancer patients undergoing surgical treatment in Xiamen Hospital of Traditional Chinese Medicine from 2019 to 2021 were collected， including 63 cases with axillary lymph node metastasis（positive group）and 67 cases without axillary lymph node metastasis (negative group). The microvascular density and microlymphatic vessel density of the cancer tissues were detected. The association of clinical data， parameters in ultrasonography， X-ray memmography and pathology with lymph node metastasis was analyzed by univariate and multivariate Logistic analysis. The nomogram prediction model for the risk of axillary lymph node metastasis in breast cancer patients was developed by R language software， and validated by receiver operating characteristic(ROC) curve. ［Results］ Delayed diagnosis and treatment was found in 57 patients (43.85%). Univariate analysis showed that delayed diagnosis and treatment， lateral location of tumor， suspected axillary lymph node before surgery， tumor diameter > 2 cm， estrogen receptor (ER) positive， and vascular cancer embolus were significantly associated with axillary lymph node metastasis. Multivariate analysis showed that delayed diagnosis and treatment (OR=5.24， 95%CI： 1.68~16.34)， suspected axillary lymph node before operation (OR=11.83， 95%CI： 3.22~43.42)， ER positive(OR=9.30， 95%CI： 2.22~39.04)， and vascular cancer embolus(OR=6.93， 95%CI： 2.29~20.96) were independent risk factors of axillary lymph node metastasis. Based on these four factors a nomogram prediction model were constructed， the area under ROC curve of the nomogram model for validation set was 0.84(95%CI： 0.67~1.00). ［Conclusion］ Delayed diagnosis and treatment， suspected axillary lymph node， ER positive and vascular cancer embolus are the independent risk factors of axillary lymph node metastasis in breast cancer patients. The nomogram prediction model constructed based on these four factors has high accuracy， indicating that it may be used for assessing the risk of axillary lymph node metastasis before surgery. |
|
在线阅读
查看全文 查看/发表评论 下载PDF阅读器 |