实用医学杂志2025，Vol.41Issue(18)：2812-2819,8.DOI:10.3969/j.issn.1006-5725.2025.18.005
联合临床及超声多参数构建列线图预测人表皮生长因子受体2阳性乳腺癌的应用价值
Study on the applied value of combined clinical and ultrasound multiparameter constructed nomogram for predicting HER-2-positive breast cancer
摘要
Abstract
Objective To evaluate the predictive value of a nomogram model developed by integrating clinical and ultrasound multiparameters for HER-2-positive breast cancer.Methods This study retrospectively enrolled 343 patients with pathologically confirmed breast cancer from three medical centers and randomly divided them into training and validation cohorts.Univariate analysis,LASSO regression,and multivariate logistic regres-sion were conducted on the training set to identify independent prognostic factors and construct a nomogram model.Bootstrap resampling with 1000 iterations was performed to evaluate the model's robustness.Model calibration was assessed using calibration curves and the Hosmer-Lemeshow goodness-of-fit test.Receiver operating characteristic(ROC)curves were generated to evaluate model discrimination,and the area under the curve(AUC)along with other performance metrics were calculated.Decision curve analysis was employed to assess the clinical utility of the model,and the validation cohort was used for external validation.Results Univariate,LASSO,and multivariate regression analyses demonstrated that age,TTP(time to peak),and the presence of a filling defect sign were independent predictors of HER-2-positive breast cancer(all P<0.05).Based on these independent predictors,a nomogram model was constructed.Bootstrap validation with 1,000 resamples indicated that the model's predictive performance was stable.The Hosmer-Lemeshow test confirmed satisfactory model calibration,while the calibration curve illustrated accurate prediction probabilities.The area under the curve(AUC)for the training set was 0.863(95%CI:0.806～0.920),and for the validation set,it was 0.846(95%CI:0.764～0.929),indicating strong discriminative and generalization capabilities.Additionally,the clinical decision curve analysis demonstrated favor-able clinical utility.Conclusion A nomogram model integrating clinical and multimodal ultrasound parameters demonstrates potential utility in predicting HER-2-positive breast cancer.关键词
乳腺癌/人表皮生长因子受体2/超声弹性成像/超声造影/列线图Key words
breast cancer/human epidermal growth factor receptor 2/ultrasound elastography/contrast-enhanced ultrasound/nomogram分类
医药卫生引用本文复制引用
张欣然,沈燕,胡姣姣,陈庆庆,肖杨杰,卢峰,袁沙沙,傅晓红..联合临床及超声多参数构建列线图预测人表皮生长因子受体2阳性乳腺癌的应用价值[J].实用医学杂志,2025,41(18):2812-2819,8.基金项目
上海市卫生健康委员会面上项目(编号:202040164) （编号:202040164）
上海市浦东新区重点专科项目(编号:PWZzk2022-18) （编号:PWZzk2022-18）
