超声分类评估法在预测乳腺癌腋窝淋巴结转移中的应用价值

The value of ultrasonic classification assessment method in predicting breast cancer axillary lymph node metastasis

目的:探讨超声分类评估法预测乳腺癌患者腋窝淋巴结转移的可行性。方法:选取南京医科大学第一附属医院收治的经病理学检查证实的1235例乳腺癌患者,按照检查时间先后顺序将其分为建模组(800例)和验证组(435例),用统计学方法对建模组特征进行筛选和赋值,将总分值分段,创建分类评估法。绘制建模组总分值的受试者工作特征(receiver operating characteristic,ROC)曲线评价该法诊断效能,再将验证组代入以验证其可靠性。结果:肿块最长径、边缘及淋巴结皮质厚度、形态分型、血供类型是腋窝淋巴结转移的独立危险因素。建模组总分值曲线下面积(area under curve,AUC)为0.783,验证组AUC为0.831,分值分段转移率符合预设。结论:超声评估分类法在预测乳腺癌腋窝淋巴结转移方面具有可靠性。

Objective:To explore the feasibility of ultrasound classification assessment method to predict axillary lymph node metastasis in breast cancer.Methods:A total of 1235 breast cancer patients admitted to The First Affiliated Hospital of Nanjing Medical University were selected and divided into a modeling group(800 cases)and a validation group(435 cases)according to the order of examination time.The statistically significant independent risk factors were screened and assigned by statistical analysis,and the total score was segmented to create a classification evaluation system.The receiver operating characteristic(ROC)curve of the total score of the modeling group was drawn to evaluate the diagnostic efficiency of the system,and then the verification group was substituted to verify the performance of the system.Results:After statistical testing,the longest diameter and margins of the mass,as well as the thickness of the lymph node cortex,morphological typology,and type of blood supply were independent risk factors for axillary lymph node metastasis.The area under curve(AUC)evaluated by the modeling group was 0.783.The AUC evaluated by the verification group was 0.831,and the probability of malignancy was consistent with the assumption.Conclusion:The new assessment classification system of conventional ultrasound is reliable in predicting breast cancer axillary lymph node metastasis.