临床误诊误治2025，Vol.38Issue(9)：37-44,8.DOI:10.3969/j.issn.1002-3429.2025.09.007
基于术前超声、肿瘤组织miR-328、ITGA5构建乳腺癌术后复发转移的预警模型及验证
Construction of an Early Warning Model and Validation for Postoperative Recurrence and Metastasis of Breast Cancer Based on Preoperative Ultra-sound,Tumor Tissue miR-328 and ITGA5
摘要
Abstract
Objective To establish and validate a warning model for recurrence and metastasis of breast cancer based on preoperative ultrasound,tumor tissue microRNA-328(miR-328)and protein integrin α5(ITGA5).Methods The clini-cal data of 286 breast cancer patients who underwent surgery in our hospital from January 2019 to July 2022 were retrospective-ly analyzed.According to the recurrence and metastasis at 2 years after surgery,they were divided into recurrence and metas-tasis group(n=62)and non-recurrence and metastasis group(n=224).The clinical data,preoperative ultrasound parame-ters(tumor diameter,morphology,spiculation,microcalcification,Alder blood flow grade,perfusion defect,enhancement in-tensity,enhancement pattern,enhancement sequence,and peripheral radial enhancement)and the levels of miR-328 and ITGA5 in tumor tissues were compared between the two groups.Multivariate logistic regression was used to analyze the influen-cing factors of postoperative recurrence and metastasis of breast cancer.Based on the results of multivariate logistic regression analysis,R language was used to draw the early warning model of postoperative recurrence and metastasis of breast cancer,and Hosmer-Lemeshow goodness of fit,calibration curve,receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to validate the established model.Results At 2 years after surgery,there were 25 patients with ipsilateral chest wall recurrence,34 patients with regional lymph node recurrence and 3 patients with both chest wall and re-gional lymph node recurrence.As for recurrence time,there was recurrence in 2 patients(3.23%)within 6 months,21 pa-tients(33.87%)within 1 year,39 patients(62.90%)within1-2 years.The proportion of patients with irregular morpholo-gy,microcalcification,perfusion defect,peripheral radial enhancement,and high expression of ITGA5 in the recurrence and metastasis group was higher than that in the non-recurrence and metastasis group,and miR-328 was lower than that in the non-recurrence and metastasis group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that irregular shape,microcalcification,perfusion defect,peripheral radial enhancement,and high expression of ITGA5 were independent risk fac-tors for postoperative recurrence and metastasis of breast cancer,and increased miR-328 was an independent protective factor for postoperative recurrence and metastasis of breast cancer(P＜0.05,P＜0.01).Based on the results of multivariate logis-tic regression analysis,irregular shape,microcalcification,perfusion defect,peripheral radial enhancement,miR-328 and ITGA5 were used to construct a warning model for postoperative recurrence and metastasis of breast cancer,and the C-index of the model was 0.837.Based on internal evaluation and external validation,the results of Hosmer-Lemeshow goodness of fit test showed that there was no significant difference between the predicted value and the actual observed value of the model(P＞0.05),and the prediction model had good calibration ability.The established model had good discrimination,the cali-bration curve was fit to the ideal curve,and the net benefit was positive at each threshold probability.Conclusion The early warning model of recurrence and metastasis of breast cancer based on preoperative ultrasound parameters,tumor tissue miR-328 and ITGA5 has a high predictive value.It can be used as a method to predict the risk of recurrence and metastasis,and provide important and objective reference information for the choice of surgical methods and perioperative intervention.关键词
乳腺肿瘤/超声检查/微小核糖核酸-328/蛋白整合素α5/肿瘤复发/灌注缺损/预警模型/危险因素Key words
Breast neoplasms/Ultrasonography/microRNA-328/Protein integrin α5/Neoplasm recurrence/Perfu-sion defect/Warning model/Risk factors分类
临床医学引用本文复制引用
周桂萍,李建柱,焦艳丽,李建梅..基于术前超声、肿瘤组织miR-328、ITGA5构建乳腺癌术后复发转移的预警模型及验证[J].临床误诊误治,2025,38(9):37-44,8.基金项目
2021年度河北省医学科学研究课题(20210772) （20210772）
