基于高频彩超联合SWE构建列线图模型诊断乳腺癌腋窝淋巴结转移的临床价值

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Diagnositicvalue of nomogram model constructed basedonhigh-frequencycolor DopperultrasoundandSWE for axillary lymph node metastasis in breast cancer

LIDong，FENGJing，RENYongfeng，LIJian，LIUFangxin，WANGShanshan DepartmentofUltrasound，Bozhou People'sHospital，Bozhou2368oo，China.

[Abstract]Objective：Toinvestigatetheclinicalvalueofnomogrammodelconstructedbasedonhigh-frequencycolorDoppler ultrasoundcombinedwithshearwaveelastography（SWE）inthediagnosisofaxilarylymphnode（ALN）metastasisinbreast cancerMethods：Theclinicaldataof118patientswithbreastcancerwereretrospectivelycolectedandanalyzed.Accordingto thepathologicalresultsof lymphnodes，thepatientsweredividedintothemetastasisgroup（51cases）andthenon-metastasis group（7cases）．The features，parametersand baselinedataofhigh-frequencycolorDopplerultrasoundandSWE were comparedbetween thetwo groups，andthediagnosticvalueof thenomogrammodelforALNmetastasiswasanalyzed.Results： The proportionsof lymph node irregular morphologyand posterior echoatenuation，the cortical thickness，ALNE ⋅max 二 Esd （204 values，andthemaximumdiameteroftheprimarytumorinthemetastasisgroupwerehigherthanthoseinthenon-metastasis group，with statistical significant differences （all P<0.05 ）. The results of LASSO algorithm and logistic regression analysis showedthathigh-frequencycolorDopplerultrasoundandSWEfeaturesandparameters（echobehindnodules，cortical thickness ，Emax value）were influencing factors of ALN metastasis in breast cancer（all P<0.05 ）.Based on the above features andparameters，anomogrammodelwasconstructed，withtheC-indexof0.86（95%CIO.799-0.925），whichhdagooddiagnostic effciency.ThedecisioncurveanalysisshowedthatwhentheriskthresholdwasintherangeofO-O.92，thenomogrammodel providedsignificantlyincreasedclinicalnetbenefitsandhadstrong clinicalapplicability.Conclusion：Thenomogrammodel basedonhigh-frequencycolorDopplerultrasoundcombinedwithSWEhashighdiagnosticvalueforALNmetastasisof breast cancer.

[Keywords]Breastcancer;Ultrasonography，Dopler，color;Shearwaveelastography;Axillrylymphnodemetastasis;Diagnosis

乳腺癌的早诊早治是决定患者预后的关键，而有无腋窝淋巴结（axillarylymphnode，ALN）转移则是辅助临床判断肿瘤临床分期、制订治疗方案并评估预后的重要决定因素之一，因此准确诊断乳腺癌ALN转移情况十分必要[1]。（剩余6969字）