常规超声及超声造影对HER-2阴性Luminal型乳腺癌患者腋窝淋巴结转移的预测价值

Predictive Value of Conventional Ultrasound and Contrast-enhanced Ultrasound in Axillary Lymph Node Metastasis in Luminal Breast Cancer Patients with HER-2 Negative

目的探讨乳腺癌原发病灶的常规超声及超声造影(CEUS)特征对HER-2阴性Luminal型乳腺癌患者腋窝淋巴结(ALN)转移的预测价值。方法选取经病理证实的HER-2阴性Luminal型乳腺癌患者110例,共计110个病灶,其中ALN转移组44个,ALN未转移组66个。分析两组病灶的常规超声及CEUS特征,筛选出独立预测因素构建列线图。结果Logistic回归分析显示血流分级Ⅱ-Ⅲ级、增强边缘放射状及增强范围扩大是HER-2阴性Luminal型乳腺癌ALN发生转移的独立预测因素,基于此构建的列线图曲线下面积(AUC)为0.812,校准曲线显示预测概率与实际值一致性良好。结论基于原发病灶血流分级、增强边缘及增强范围构建的列线图对HER-2阴性Luminal型乳腺癌患者ALN转移具有预测价值,可作为临床诊疗决策参考工具。

Objective To explore the predictive value of conventional ultrasound and contrast-enhanced ultrasound(CEUS)in axillary lymph node(ALN)metastasis in Luminal breast cancer patients with HER-2 negative.Methods A total of 110 patients with HER-2 negative Luminal breast cancer confirmed by pathology were selected,with a total of 110 lesions,including 44 in the ALN metastasis group and 66 in the non-metastatic ALN group.The features of conventional ultrasound and CEUS were analyzed,and the independent risk factors were screened to construct a nomogram.Results Logistic regression analysis showed that blood flow gradeⅡ-Ⅲ,radial enhanced margin and enlarged enhancement area were independent risk factors of ALN metastasis in HER-2 negative Luminal breast cancer.The area under the curve(AUC)of the nomogram based on this model was 0.812,and the calibration curve showed that the predicted probability was in good agreement with the actual value.Conclusion The nomogram based on blood flow grade,enhancement margin and enhancement area of the primary lesion has predictive value for ALN metastasis in patients with HER-2 negative Luminal breast cancer,which can be used as a reference tool for clinical diagnosis and treatment decisions.