超声及其他多因素在乳腺癌腋窝淋巴结转移中的预测价值

目的探讨超声等多种因素在乳腺癌腋窝淋巴结转移中的预测价值。方法对288例乳腺癌患者的病史资料进行回顾性分析,利用多因素Logistic回归分析年龄、腋窝淋巴结超声评价、肿块大小、位置、周边血管侵犯、病理分级、ER、PR、Her-2及Ki-67在乳腺癌腋窝淋巴结转移中的预测价值。结果超声评分、肿块、肿瘤周边血管浸润、Ki-67、Her-2及病理分级进入Logistic回归方程,其中超声评分≥3、肿块>2cm及肿瘤周边血管浸润阳性的比数比(OR)最大,分别为26.510,24.222及15.041。Logistic模型的确诊率、敏感性及特异性分别为98.1%,90.6%和95.7%。结论腋窝淋巴结超声评价≥3、肿块大小>2cm、肿块周边血管浸润阳性、病理分级Ⅲ级、Her-2阳性及Ki-67指数>15%是腋窝淋巴结转移的独立预测因素。

Predictive value of ultrasonography and other multiple factors in breast cancer axillary lymph nodes metastasis

Objective To explore the predictive value of ultrasonography and other multiple factors in the axillay lymph nodes metastasis of breast cancer.Methods The medical records of 288 patients with breast cancer were respectively analyzed.Multivariate logistic regression analysis was performed to analyze the predictive value of age,axillae ultrasonography,tumor size,tumor location,peritumoral vascular invasion(PVI),histopathological grade,ER,PR,Her-2 and Ki-67 index in axillae involvement of breast cancer.Results Ultrasonography score,tumor size,PVI,Ki-67 index,Her-2 and histopathological grade were introduced into the logistic regression equation successively.Ultrasonography score≥3,tumor size>2 cm and PVI positive announced the most powerful odd ratio(OR),which was 26.510,24.222 and 15.041,respectively.The overall accuracy,sensitivity and specificity of the logistic model were 98.1%,90.6% and 95.7% respectively.Conclusions Ultrasonography score≥3,tumor size>2 cm,PVI positive,Ki-67 index>15%,Her-2 positive and histopathological grade Ⅲ are the independent predictive factors in axillary lymph nodes metastasis of breast cancer.