摘要
目的:探讨基于高频彩超联合剪切波弹性成像(SWE)构建列线图模型诊断乳腺癌腋窝淋巴结(ALN)转移的临床价值。方法:回顾性收集118例乳腺癌患者,根据淋巴结病理结果分为转移组(51例)与无转移组(67例)。比较2组高频彩超与SWE征象、参数及基线资料,并分析基于高频彩超联合SWE构建的列线图对乳腺癌ALN转移的诊断价值。结果:转移组淋巴结形态不规则、后方回声衰减占比、皮质厚度、ALN弹性模量最大值(E_(max))、弹性模量平均值(E_(mean))、弹性模量标准差(E_(sd))均大于无转移组,差异均有统计学意义(均P<0.05)。转移组原发肿瘤最大径大于无转移组(P<0.05)。最小绝对收缩和选择算子(LASSO)算法与logistic回归分析显示,高频彩超及SWE征象与参数(淋巴结后方回声、皮质厚度、E_(max))均为乳腺癌ALN转移的独立影响因素(均P<0.05)。基于高频彩超及SWE征象与参数(淋巴结后方回声、皮质厚度、E_(max))构建列线图模型发现,其诊断乳腺癌ALN转移的C指数为0.862(95%CI 0.799~0.925),诊断效能良好。决策曲线分析显示,当风险阈值在0~0.92时,列线图模型可提供显著增加的临床净收益,临床适用性较强。结论:基于高频彩超联合SWE构建的列线图模型对乳腺癌ALN转移有较高诊断价值。
Objective:To investigate the clinical value of nomogram model constructed based on high-frequency color Doppler ultrasound combined with shear wave elastography(SWE)in the diagnosis of axillary lymph node(ALN)metastasis in breast cancer.Methods:The clinical data of 118 patients with breast cancer were retrospectively collected and analyzed.According to the pathological results of lymph nodes,the patients were divided into the metastasis group(51 cases)and the non-metastasis group(67 cases).The features,parameters and baseline data of high-frequency color Doppler ultrasound and SWE were compared between the two groups,and the diagnostic value of the nomogram model for ALN metastasis was analyzed.Results:The proportions of lymph node irregular morphology and posterior echo attenuation,the cortical thickness,ALN E_(max),E_(mean),E_(sd)values,and the maximum diameter of the primary tumor in the metastasis group were higher than those in the non-metastasis group,with statistical significant differences(all P<0.05).The results of LASSO algorithm and logistic regression analysis showed that high-frequency color Doppler ultrasound and SWE features and parameters(echo behind nodules,cortical thickness,E_(max)value)were influencing factors of ALN metastasis in breast cancer(all P<0.05).Based on the above features and parameters,a nomogram model was constructed,with the C-index of 0.862(95%CI 0.799—0.925),which had a good diagnostic efficiency.The decision curve analysis showed that when the risk threshold was in the range of 0—0.92,the nomogram model provided significantly increased clinical net benefits and had strong clinical applicability.Conclusion:The nomogram model based on high-frequency color Doppler ultrasound combined with SWE has high diagnostic value for ALN metastasis of breast cancer.
作者
黎栋
冯景
任永凤
李健
刘芳欣
王珊珊
LI Dong;FENG Jing;REN Yongfeng;LI Jian;LIU Fangxin;WANG Shanshan(Department of Ultrasound,Bozhou People’s Hospital,Bozhou 236800,China)
出处
《中国中西医结合影像学杂志》
2025年第4期477-481,521,共6页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
安徽医科大学2022年度校科研基金立项资助项目(2022xkj231)
安徽医科大学附属医院青年科技人才培养项目“雏鹰计划”(2023cy006)。
关键词
乳腺癌
超声检查
多普勒
彩色
剪切波弹性成像
腋窝淋巴结转移
诊断
Breast cancer
Ultrasonography,Doppler,color
Shear wave elastography
Axillary lymph node metastasis
Diagnosis
作者简介
通信作者:冯景,Email:393172861@qq.com。
