郑州大学学报（医学版）2023，Vol.58Issue(6)：847-852,6.DOI:10.13705/j.issn.1671-6825.2023.06.044
基于超声特征构建的列线图模型对肿块型乳腺导管原位癌与导管内乳头状瘤的鉴别诊断价值
Value of a nomogram model based on ultrasound characteristics for lumps ductal carcinoma in situ and intraductal papilloma of the breast in differ-ential diagnosis
穆晓伟 1原瑞霞 2滑少华 1王肖辉 1曾庆虎1
作者信息
- 1. 郑州大学第一附属医院超声科 郑州 450052
- 2. 郑州大学第一附属医院临床医学大数据中心 郑州 450052
- 折叠
摘要
Abstract
Aim:To explore the value of a nomogram model based on clinical data and color Doppler ultrasound char-acteristics in the differential diagnosis of lumps ductal carcinoma in situ(DCIS)of the breast and intraductal papilloma.Methods:Clinical data of 185 patients(185 lesions)with lumps DCIS of the breast and 193 patients(193 lesions)with in-traductal papilloma of the breast confirmed by surgery and pathology were retrospectively analyzed.The differences of clini-cal data and ultrasound examination indicators were compared,and the statistically significant variables were put into Logis-tic regression analysis to screen the influencing factors for the identification of lumps DCIS of the breast.Based on the above results,the R language was used to construct a nomogram model.ROC curve was drawn to evaluate the diagnostic efficiency of the model.The 10-fold cross test was applied to evaluate the stability and generalization ability of the model.The Hosmer-Lemeshow test and calibration curve were used to evaluate the goodness of fit and calibration of the model.The clinical deci-sion curve was drawn to evaluate the clinical benefits.Results:The factors for distinguishing lumps DCIS from intraductal papilloma of the breast were age,length of nodule,distance from nipple,calcification and blood flow(P<0.05).The AUC of ROC curve of the nomogram model was 0.778(95%CI:0.732-0.824),with a sensitivity of 80.3%and a specificity of 61.1%.The model had good predictive performance.The 10-fold cross test showed that the average AUC of the model was 0.659,and Hosmer-Lemeshow test showed that the model fitted well(P =0.231).The calibration curve showed that the prediction probability of the model was in good agreement with the actual pathological results(C-index:0.759).The clini-cal decision curve showed that the model had good clinical practical value.Conclusion:The nomogram model based on ul-trasonic features has good value in differentiating lumps DCIS from intraductal papilloma of the breast.关键词
超声检查/乳腺导管原位癌/乳腺导管内乳头状瘤/列线图Key words
ultrasonography/ductal carcinoma in situ of the breast/intraductal papilloma of the breast/nomogram分类
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穆晓伟,原瑞霞,滑少华,王肖辉,曾庆虎..基于超声特征构建的列线图模型对肿块型乳腺导管原位癌与导管内乳头状瘤的鉴别诊断价值[J].郑州大学学报（医学版）,2023,58(6):847-852,6.
