超声图像对乳腺导管原位癌患者HER-2表达的预测价值

Predictive value of ultrasound images for HER-2 expression in patients with breast ductal carcinoma in situ

目的建立基于超声图像特征的预测模型,并探讨该模型预测乳腺导管原位癌患者人表皮生长因子受体2(HER-2)表达的价值。方法选取2016年10月至2020年6月于屯昌县人民医院就诊的126例乳腺导管原位癌患者为研究对象,收集患者入院时超声图像特征,并收集患者入院治疗后1年的HER-2表达情况,根据患者HER-2表达分为阳性组(67例)和阴性组(59例),比较两组患者临床资料,采用logistics回归方程分析影响乳腺导管原位癌患者HER-2表达的影响因素,并构建基于超声图像特征的预测模型,分析其预测乳腺导管原位癌患者HER-2表达的价值。结果单变量分析显示阳性组乳腺导管原位癌级别、形状不规则、边界不清晰、边缘毛刺、内部微钙化、腋窝淋巴结转移比例比较,差异有统计学意义(χ^(2)=3.002、5.911、4.456、2.363、8.374、10.730,P均<0.05);Logistics分析显示高临床分期乳腺导管原位癌、边缘毛刺、内部微钙化、腋窝淋巴结转移是影响乳腺导管原位癌患者HER-2表达的影响因素(OR=0.073、1.448、0.550、0.481,P均<0.05);列线图分析显示该预测模型预测乳腺导管原位癌患者HER-2表达的C-index为0.732,校正曲线显示预测可能性绝对误差为0.042。结论边缘毛刺、内部微钙化、高临床分期乳腺导管原位癌、腋窝淋巴结转移是影响乳腺导管原位癌患者HER-2表达的影响因素,基于此建立的预测模型可预测乳腺导管原位癌患者HER-2的表达。

Objective To establish a prediction model based on the features of ultrasound imag-es,and to explore the value of this model in predicting the expression of human epidermal growth factor receptor 2(HER-2)in patients with ductal carcinoma in situ of the breast.Methods 126 patients with breast ductal carcinoma in situ who were treated at Tunchang County People's Hospital from October 2016 to June 2020 were selected as the research subjects.Ultrasound image characteristics were collected when the patients were admitted to the hospital,and HER-2 levels were collected 1 year after the patients were admitted to the hospital.According to the HER-2 expression of the patients,they were divided into a positive group(67 cases)and a negative group(59 cases).The clinical data of the two groups of patients were compared.The logistic regression equation was used to analyze the influencing factors of HER-2 expression in patients with breast ductal carcinoma in situ.A prediction model based on ultrasound image features was constructed to analyze its value in predicting HER-2 expression in patients with breast ductal carcinoma in situ.Results Univariate analysis showed that there were significant differences in the proportion of breast ductal carcinoma in situ,irregular shape,unclear boundary,marginal burr,internal microcalcification and axillary lymph node metastasis in the positive group(χ^(2)=3.002,5.911,4.456,2.363,8.374,10.730,P<0.05).Logistics analysis showed that high clinical stage breast ductal carcinoma in situ,edge burrs,internal microcalcifications,and axillary lymph node metastasis are influencing factors for HER-2 expression in patients with breast ductal carcinoma in situ(OR=0.073,1.448,0.550,0.481,P<0.05).Nomogram analysis showed that the C-index of the prediction model for predicting HER-2 expression in patients with breast ductal carcinoma in situ was 0.732,and the calibration curve showed that the absolute error of the prediction probability was 0.042.Conclusion Marginal burrs,internal microcalcification,high clinical stage breast ductal carcinoma in situ,and axillary lymph node metastasis are influential factors affecting the expression of HER-2 in patients with ductal carcinoma in situ of the breast.The prediction model established based on this can predict ductal carcinoma in situ of HER-2 expression in patients.