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基于超声图像形态学特征对早期浸润性乳腺癌患者淋巴结状态的无创预测

Non-invasive prediction of lymph node status for patients with early-stage invasive breast cancer based on a morphological feature from ultrasound images.

作者信息

Jiang Tao, Su Weiwei, Zhao Yanan, Li Qunying, Huang Pintong

机构信息

Department of Ultrasound, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Quant Imaging Med Surg. 2021 Aug;11(8):3399-3407. doi: 10.21037/qims-20-1201.

Abstract

BACKGROUND

This study aimed to estimate the value of a morphological feature on ultrasound (US) for preoperative diagnosis of axillary lymph node (ALN) status in patients with early-stage invasive breast cancer (ESIBC).

METHODS

In this retrospective work, a total of 239 ESIBC patients, were recruited, and their preoperative US images and postoperative pathology results were collected. The relationship between US images based on morphological features and ALN metastasis was investigated. The tumor circularity and US-reported ALN status were developed as a nomogram to predict the ALN status.

RESULTS

Among the 239 participants, 82 (34.31%) had ALN metastasis, and 157 (65.69%) did not. There was a statistically significant difference in tumors between participants diagnosed with and without ALN metastasis. The median value was 0.47 0.62 (P<0.001) in the training group, respectively, and the value was 0.50 0.60 (P<0.001) in the validation group, respectively. The clinical model nomogram was shown to have high efficiency in predicting ALN status among our research population. The area under the curve (AUC) was 0.89 in the training group and 0.90 in the validation group and the accuracy was 85.79% and 81.63%, respectively.

CONCLUSIONS

The clinical model nomogram based on tumor circularity and US-reported ALN status is a non-invasive approach for ALN metastasis prediction in ESIBC patients with high efficacy.

摘要

背景

本研究旨在评估超声(US)形态学特征对早期浸润性乳腺癌(ESIBC)患者腋窝淋巴结(ALN)状态术前诊断的价值。

方法

在这项回顾性研究中,共纳入239例ESIBC患者,收集其术前超声图像和术后病理结果。研究基于形态学特征的超声图像与ALN转移之间的关系。将肿瘤圆形度和超声报告的ALN状态构建为列线图以预测ALN状态。

结果

239名参与者中,82例(34.31%)发生ALN转移,157例(65.69%)未发生转移。在诊断为有或无ALN转移的参与者之间,肿瘤存在统计学显著差异。训练组中位数分别为0.47和0.62(P<0.001),验证组中位数分别为0.50和0.60(P<0.001)。临床模型列线图在我们的研究人群中显示出对预测ALN状态具有高效性。训练组曲线下面积(AUC)为0.89,验证组为0.90,准确率分别为85.79%和81.63%。

结论

基于肿瘤圆形度和超声报告的ALN状态的临床模型列线图是一种用于预测ESIBC患者ALN转移的非侵入性方法,具有高效性。

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