磁共振成像2026，Vol.17Issue(8)：88-97,10.DOI:10.12015/issn.1674-8034.2026.08.009
多模态MRI联合临床病理预测乳腺癌新辅助治疗后腋窝淋巴结病理完全缓解
Multimodal MRI combined with clinicopathological indicators to predict pathological complete response of axillary lymph nodes after neoadjuvant therapy for breast cancer
彭雪华 1王新正 1黎瑞枫 1陈翠美 1吕蕙芯 1易芹芹2
作者信息
- 1. 龙华区人民医院医学影像科,深圳 518109
- 2. 深圳市人民医院放射科,深圳 518020
- 折叠
摘要
Abstract
Objective:To establish a prediction model for axillary pathological complete response(pCR)after neoadjuvant therapy(NAT)in breast cancer patients with initially positive axillary lymph nodes,by integrating multimodal MRI features of the breast,axillary lymph nodes and peritumoral region before and after treatment,as well as clinicopathological indicators,and to evaluate its predictive performance.Materials and Methods:A retrospective analysis was performed on patients with breast cancer and axillary lymph node metastasis admitted to our hospital from January 2022 to August 2025.MR imaging data and clinicopathological information before and after NAT were collected.Patients were randomly divided into a training set and a validation set at a ratio of 8:2.Logistic regression was used to screen independent predictors of axillary pCR and construct a nomogram.The model performance was assessed using receiver operating characteristic(ROC)curves,calibration curves and decision curve analysis(DCA),and bootstrap resampling(1000 times)was performed for internal validation to evaluate model stability.Results:A total of 197 patients were included,with an axillary pCR rate of 58.38％.Positive HER-2 status,disappearance of peritumoral edema after NAT,and non-enhancement of residual lesions were identified as independent predictive factors(P＜0.05).The model achieved an area under the ROC curve(AUC)of 0.895(95％CI:0.839 to 0.943)in the training set and 0.895(95％CI:0.773 to 0.984)in the validation set.The bootstrap-corrected optimism-corrected AUC was 0.893(95％CI:0.846 to 0.944).The Hosmer-Lemeshow test indicated good model fitting,and DCA showed significant net clinical benefit within a threshold probability range of 12％to 90％.Conclusions:The model established in this study can effectively predict axillary pCR after NAT in breast cancer patients with initially positive axillary lymph nodes,with favorable discrimination and calibration.It can provide evidence for individualized surgical decision-making for the axilla,reduce unnecessary axillary lymph node dissection(ALND),and improve patient prognosis.关键词
乳腺癌/磁共振成像/新辅助治疗/腋窝淋巴结/病理完全缓解Key words
breast cancer/magnetic resonance imaging/neoadjuvant therapy/axillary lymph nodes/pathological complete response分类
医药卫生引用本文复制引用
彭雪华,王新正,黎瑞枫,陈翠美,吕蕙芯,易芹芹..多模态MRI联合临床病理预测乳腺癌新辅助治疗后腋窝淋巴结病理完全缓解[J].磁共振成像,2026,17(8):88-97,10.
