肿瘤预防与治疗2025，Vol.38Issue(5)：387-397,11.DOI:10.3969/j.issn.1674-0904.2025.05.005
超声造影结合临床特征在乳腺癌腋窝淋巴结转移中的预测价值研究
Predicting Axillary Lymph Node Metastasis in Breast Cancer Using Con-trast-Enhanced Ultrasound and Clinical Features
摘要
Abstract
Objective:This study aimed to evaluate the clinical value of contrast-enhanced ultrasound(CEUS)integrat-ed with clinical features in predicting the presence of axillary lymph node metastasis in breast cancer patients,and develop a predictive model to guide individualized treatment.Methods:Female breast cancer patients who underwent surgery between March 2017 and March 2023 were included in this study.All patients received preoperative CEUS examination for sentinel lymph nodes(SLN).Based on CEUS enhancement patterns,SLN were categorized into four types:homogeneous enhance-ment,heterogeneous enhancement,no enhancement,and rim enhancement.Univariate and multivariate logistic regression analyses were performed using baseline clinical characteristics and pathological data to assess CEUS patterns and clinicopath-ological factors as independent predictors of SLN metastasis.Results:A total of 508 patients were included in the final anal-ysis based on the inclusion and exclusion criteria.Multivariable logistic regression analysis revealed that patient age,the homogeneity of SLN enhancement patterns,and the clarity of SLN boundaries with surrounding tissues were independent pre-dictors of SLN metastasis.The nomogram incorporating these predictors exhibited moderate discriminative ability,achieving an AUC of 0.707 in the training cohort and 0.645 in the validation cohort.The calibration curves and Hosmer-Lemeshow test indicated good model fit in both the training set(P=0.74)and the validation set(P=0.68).Conclusion:CEUS,com-bined with clinical characteristics,effectively predicts the risk of lymph node metastasis in breast cancer patients by assessing SLN enhancement patterns.This method provides valuable guidance for preoperative individualized assessment and decision-making,demonstrates potential to reduce unnecessary surgical interventions and improving patients'quality of life.Further multicenter studies are required to validate its clinical applicability.关键词
超声造影/乳腺癌/前哨淋巴结/腋窝淋巴结转移Key words
Contrast-enhanced ultrasound(CEUS)/Breast cancer/Sentinel lymph node(SLN)/Axillary lymph node metastasis(ALNM)分类
医药卫生引用本文复制引用
刘双华,王美华,王浩,李卓璇,龙璐,李婷媛,孟佳乐..超声造影结合临床特征在乳腺癌腋窝淋巴结转移中的预测价值研究[J].肿瘤预防与治疗,2025,38(5):387-397,11.基金项目
四川省自然科学基金(编号:2025ZNSFSC0563) This study was supported by Natural Science Foundation of Sichuan Province(No.2025ZNSFSC0563). （编号:2025ZNSFSC0563）
