A Prediction Model Of Axillary Lymph Node Metastasis Was Established Based On The Clinical And Ultrasound Features Of Breast Cancer

Objective: Comprehensive analysis of clinical data of breast cancer patients,primary and ultrasound signs of axillary lymph nodes,histopathology,molecular biological characteristics,to explore the relationship with breast cancer axillary lymph node metastasis,breast cancer axillary lymph node metastasis prediction model,through the model preoperative more fully understand the axillary lymph nodes,provide certain reference for clinicians comprehensive treatment decision.Methods: 182 patients with invasive breast cancer diagnosed by axillary lymph node dissection of Mianyang Central Hospital from January 2020 to December2021,whose age,ultrasound signs(primary lesion,axillary lymph node),pathological data(pathological type,molecular classification,E-Cadherin protein,Ki-67 status)were collected,with postoperative pathological examination results as the gold standard,including patients with axillary lymph node metastasis in pathological diagnosis results as the positive group,and the rest without axillary lymph node metastasis as the negative group.The indicators were analyzed one by one and the data types affecting the properties of the axillary lymph nodes were selected.The prediction model of the axillary lymph node metastasis in breast cancer was established according to the results of the binary logistic regression analysis.The receiver operating characteristic curve(ROC)and the area under the curve(AUC)were evaluated to test the repeatability of the model.Results: Univariate analysis suggested that mass diameter greater than 2cm,mass quadrant of coexistence,mass calcification,mass flow distribution,lymph node diameter ratio less than 2,cortical thickness greater than 1 / 2 of lymphatic diameter,medulla disappearance,lymph node boundary,lymph node flow signal peripheral or mixed,breast cancer molecular classification,high expression of Ki-67 is associated with axillary lymph node metastasis(P <0.05).Patient age,mass location,morphology of the mass,mass boundary,lymph node size,pathology type,and E-Cadherin protein were not associated with axillary lymph node metastasis.(P> 0.05)Multivariate logistic regression analysis suggested that the mass quadrant,mass flow distribution,lymph node aspect diameter ratio less than 2,and lymph node cortical thickness greater than1 / 2 of the lymphatic valve diameter could independently predict the metastasis of axillary lymph nodes in breast cancer patients(OR values were0.373,3.243,3.252,and 4.067,respectively).The prediction model of axillary lymph node metastasis in breast cancer was established: logit P=1.376-0.986A+1.176B+1.179C+1.403D(A is the mass in the outer upper quadrant,B is the mass with blood flow distribution,C is the lymph node aspect diameter ratio <2,and D is the diameter of the cortical thickness of lymph nodes).The area under the curve of the model is 0.850.According to the Youden index,the predicted best cut-off value is 0.599,when the sensitivity is0.773 and the specificity is 0.825.Conclusion: 1.Color Doppler ultrasound examination can better evaluate the axillary lymphatic status in breast cancer patients.2.The mass quadrant and the mass have blood flow distribution,the lymph node aspect diameter ratio is <2,and 1 / 2 of the lymph node cortex thickness lymphatic portal diameter can be independently predicted...