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[1]黃蓓蕾,王月桂,陳紅,等.PR基因表達(dá)聯(lián)合超聲影像構(gòu)建HER2陰性乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移預(yù)測模型及應(yīng)用[J].福建醫(yī)藥雜志,2024,46(08):1-5.[doi:10.20148/j.fmj.2024.08.001]
　HUANG Beilei,WANG Yuegui,CHEN Hong,et al.Prediction model of axillary lymph node metastasis in HER2 negative breast cancer by PR gene expression combined with ultrasound image and its application[J].FUJIAN MEDICAL JOURNAL,2024,46(08):1-5.[doi:10.20148/j.fmj.2024.08.001]
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PR基因表達(dá)聯(lián)合超聲影像構(gòu)建HER2陰性乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移預(yù)測模型及應(yīng)用 ()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
46
期數(shù):
2024年08期
頁碼:
1-5
欄目:
臨床研究
出版日期:
2024-12-20

文章信息/Info

Title:
Prediction model of axillary lymph node metastasis in HER2 negative breast cancer by PR gene expression combined with ultrasound image and its application
文章編號:
1002-2600(2024)08-0001-05
作者:
黃蓓蕾; 王月桂; 陳紅; 廖建梅; 沈浩霖
福建醫(yī)科大學(xué)附屬漳州市醫(yī)院超聲科,漳州 363000
Author(s):
HUANG Beilei; WANG Yuegui; CHEN Hong; LIAO Jianmei; SHEN Haolin
Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian 363000, China
關(guān)鍵詞:
乳腺癌;  腋窩淋巴結(jié);  轉(zhuǎn)移;  PR基因;  超聲
Keywords:
breast cancer;  axillary lymph node;  metastasis;  PR gene;  ultrasound
分類號:
R737.9; R445.1
DOI:
10.20148/j.fmj.2024.08.001
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 探討孕激素受體(PR)基因表達(dá)聯(lián)合常規(guī)超聲影像評估人表皮生長因子受體2(HER2)陰性乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移(ALNM)的危險因素,構(gòu)建超聲預(yù)測模型并評估其價值。方法 回顧性收集281例HER2陰性乳腺癌患者的臨床資料,根據(jù)術(shù)后病理結(jié)果將患者分為轉(zhuǎn)移組和未轉(zhuǎn)移組,按8:2分成訓(xùn)練集與測試集。在訓(xùn)練集中,通過logistic回歸分析,篩選出與結(jié)局相關(guān)的獨立危險因素,建立預(yù)測模型。在測試集中,計算相關(guān)指標(biāo)來評估模型的性能。結(jié)果 單因素分析及多因素分析結(jié)果顯示,簇狀鈣化、高回聲暈、后方回聲伴衰減、PR基因表達(dá)陽性是HER2陰性乳腺癌患者ALNM的獨立危險因素(P<0.05)。預(yù)測模型為:Y=-5.28+0.90×簇狀鈣化(0:無; 1:有)+1.22×高回聲暈(0:無; 1:有)+2.06×后方回聲衰減(0:無; 1:有)-1.34×Ki_67(表達(dá)水平為5%～30% 時為1,否則為0)+0.75×Ki_67(表達(dá)水平為>30%時為1,否則為0)+3.79×PR基因表達(dá)(0:陰性; 1:陽性)+0.71×腫塊最大徑(超過2 cm為1,否則為0)。Hosmer-Lemeshow擬合優(yōu)度檢驗結(jié)果P=0.110。在訓(xùn)練集中,模型一致性指數(shù)(C指數(shù))達(dá)0.870。當(dāng)模型分值≥0.495,認(rèn)為存在ALNM。在測試集中,模型C指數(shù)為0.812,模型診斷ALNM的靈敏度、特異度、陽性預(yù)測值、陰性預(yù)測值和準(zhǔn)確率分別為0.750、0.679、0.700、0.731和0.714。結(jié)論 簇狀鈣化、高回聲暈、后方回聲伴衰減和PR基因表達(dá)陽性是HER2陰性乳腺癌腋窩淋巴結(jié)發(fā)生轉(zhuǎn)移的獨立危險因素。所構(gòu)建的風(fēng)險預(yù)測模型可以較好地預(yù)測乳腺癌ALNM。
Abstract:
Objective To explore the risk factors for axillary lymph node metastasis(ALNM)in human epidermal growth factor receptor 2(HER2)negative breast cancer by combining the expression of progesterone receptor(PR)gene with conventional ultrasound images, and to construct an ultrasound prediction model and evaluate its value.Methods The clinical data of 281 HER2 negative breast cancer patients were retrospectively collected.According to the postoperative pathological results, the patients were divided into metastatic group and non-metastatic group, and divided into training set and test set in the ratio of 8:2.In the training set, the logistic regression analysis was used to screen out the independent risk factors associated with the outcome, and a prediction model was established.In the test set, the relevant metrics were calculated to evaluate the performance of the model.Results The results of univariate analysis and multivariate analysis showed that clustered calcification, hyperechoic halo, posterior acoustic attenuation and positive PR gene expression were independent risk factors for ALNM in HER2 negative breast cancer patients(P<0.05).The prediction model was: Y=-5.28+0.90×clustered calcification(0: absent; 1:present)+1.22×hyperechoic halo(0: absent; 1: present)+2.06×posterior acoustic attenuation(0: absent; 1: present)-1.34×Ki_67(1 at an expression level of 5%-30%, otherwise 0)+0.75× Ki_67(1 at expression level>30%, otherwise 0)+3.79×PR gene expression(0: negative; 1: positive)+0.71×maximum tumor diameter(1 over 2 cm, otherwise 0).The Hosmer-Lemeshow goodness-of-fit test showed P=0.110. In the training set, the model consistency index(C index)reached 0.870. When the model score was≥0.495,the presence of ALNM was considered.In the test set, the model C index was 0.812, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the model in diagnosing ALNM were 0.750, 0.679, 0.700, 0.731 and 0.714,respectively.Conclusion Clustered calcification, hyperechoic halo, posterior acoustic attenuation and positive PR gene expression were independent risk factors for axillary lymph node metastasis of HER2 negative breast cancer, and the constructed risk prediction model can well predict ALNM of breast cancer.

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備注/Memo

備注/Memo:
基金項目:福建省自然科學(xué)基金項目(2023J011813)
通信作者:沈浩霖,Email: [email protected]
更新日期/Last Update: 2024-12-20