摘要
目的观察基于常规超声表现的列线图预测乳腺非肿块型病变(NML)恶性风险的效能。方法回顾性分析113例女性患者共120个经超声诊断的NML,根据病理结果将其分为恶性组(n=44)与良性组(n=76);比较组间患者年龄、NML及同侧腋窝淋巴结超声表现,基于多因素logistic回归模型构建列线图,并验证其诊断效能及准确性。结果组间患者年龄≥45岁和同侧腋窝淋巴结异常占比,以及NML最大径≥2 cm、后方回声衰减、血流信号丰富、结构扭曲及微钙化占比差异均有统计学意义(P均<0.05)。年龄≥45岁、同侧腋窝淋巴结异常,以及NML血流信号丰富、结构扭曲及微钙化均为提示乳腺NML恶性风险高的独立预测因素(P均<0.05);以之构建的列线图预测乳腺NML恶性风险的受试者工作特征曲线的曲线下面积为0.901,且其预测概率与实际概率一致性高(Hosmer-Lemeshow检验P>0.05)。结论结合患者年龄、NML及同侧腋窝淋巴结超声表现构建的列线图可有效量化评估乳腺NML恶性风险。
Objective To observe the efficacy of a nomogram based on conventional ultrasonic manifestations for predicting malignant risk of breast non-mass lesions(NML).Methods A total of 120 NML diagnosed with ultrasound in 113 female patients were retrospectively included and divided into malignant group(n=44)and benign group(n=76)based on pathological results.Patients’age,ultrasonic manifestations of NML and ipsilateral axillary lymph node were compared between groups.Then a nomogram was constructed using a multivariable logistic regression model,and its diagnostic performance and accuracy were validated.Results The ratios of patients’aged≥45 years,with abnormal ipsilateral axillary lymph nodes,NML with maximum diameter≥2 cm,posterior echo attenuation,rich blood flow signals,architectural distortion and microcalcification were significantly different between groups(all P<0.05).Patient’s age≥45 years,with abnormal ipsilateral axillary lymph nodes,and NML with rich blood flow signals,architectural distortion and microcalcification were all independent predictive factors for high malignant risk of breast NML(all P<0.05).The constructed nomogram achieved an area under the receiver operating characteristic curve of 0.901 for predicting malignant risk of breast NML,and its predicting probabilities demonstrated good agreement with the actual probabilities(Hosmer-Lemeshow test P>0.05).Conclusion The nomogram incorporating patient’s age,ultrasonic manifestations of NML and ipsilateral axillary lymph node could effectively quantify malignancy risk of breast NML.
作者
金金
张巍
何文
于腾飞
程令刚
JIN Jin;ZHANG Wei;HE Wen;YU Tengfei;CHENG Linggang(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中国医学影像技术》
北大核心
2025年第10期1677-1681,共5页
Chinese Journal of Medical Imaging Technology
关键词
乳腺肿瘤
超声检查
乳房
诊断
鉴别
列线图
breast neoplasms
ultrasonography,mammary
diagnosis,differential
nomograms
