Predicting level 2 axillary lymph node metastasis in a Chinese breast cancer population post-neoadjuvant chemotherapy: development and assessment of a new predictive nomogram.
Predicting level 2 axillary lymph node metastasis in a Chinese breast cancer population post-neoadjuvant chemotherapy: development and assessment of a new predictive nomogram.
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预测中国乳腺癌人群新辅助化疗后 2 级腋窝淋巴结转移：新预测列线图的开发和评估
DOI：
10.18632/oncotarget.16131
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发表时间：
2017-10-03
期刊：
影响因子：
--
通讯作者：
Guo Q
中科院分区：
文献类型：
--
作者：
Liu C;Jiang Y;Gu X;Xu Z;Ai L;Zhang H;Chen G;Sun L;Li Y;Xu H;Gu H;Yu Y;Xu Y;Guo Q
研究背景：我们的目的是建立一种新的诺模图来预测乳腺癌（BC）患者接受新辅助化疗（NAC）后发生2级腋窝淋巴结转移（L-2-ALNM）的概率。方法收集2009年5月至2015年12月在辽宁省肿瘤医院接受新辅助化疗并接受腋窝淋巴结（ALN）清扫的709例患者的数据。根据Logistic回归模型建立2级腋窝淋巴结转移（L-2-ALNM）列线图。2015年1月至2015年12月期间在同一机构接受治疗的另外一组141例连续患者入组为验证组。通过计算受试者工作特征曲线下面积（AUC）来测量L-2-ALNM列线图的预测准确性。结果在多因素分析中，年龄、肿瘤大小、组织学分级、皮肤浸润和对新辅助化疗的反应被确定为L-2-ALNM的独立预测因素。新模型对于建模组和验证组都是准确和有区别的（AUC：0.819 vs 0.849）。L-2-ALNM列线图的假阴性率分别为4.44%和7.69%。结论L-2-ALNM列线图对临床决策具有一定的准确性。根据医务人员和患者确定的可接受风险，如果2级淋巴结受累的概率< 10%或< 20%，则新辅助化疗后有可能遗漏2级腋窝淋巴结清扫。
Background We aimed to develop a new nomogram to predict the probability of level 2 axillary lymph node metastasis (L-2-ALNM) in breast cancer (BC) patients treated with neoadjuvant chemotherapy (NAC). Methods Data were collected from 709 patients who received neoadjuvant chemotherapy and then underwent axillary lymph node (ALN) dissection between May 2009 and December 2015 at the Liaoning Cancer Hospital. The level 2 axillary lymph node metastasis (L-2-ALNM ) nomogram was created from the logistic regression model. An additional set of 141 consecutive patients treated at the same institution between January 2015 and December 2015 were enrolled as the validation group. The predictive accuracy of the L-2-ALNM nomogram was measured by calculating the area under the receiver operating characteristic curve (AUC). Results In multivariate analysis, age, tumor size, histological grade, skin invasion, and response to neoadjuvant chemotherapy were identified as independent predictors of L-2-ALNM. The new model was accurate and discriminating for both the modeling and validation groups (AUC: 0.819 vs 0.849). The false-negative rates of the L-2-ALNM nomogram were 4.44% and 7.69% for the predicted probability cut-off points of 10% and 20%. Conclusion The L-2-ALNM nomogram shows reasonable accuracy for making clinical decisions. The omission of level 2 axillary lymph node dissection after neoadjuvant chemotherapy might be possible if the probability of level 2 lymph node involvement was < 10% or < 20% in accordance with the acceptable risk determined by medical staff and patients.
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影响因子：
4.6
作者：
Jin X;Jiang YZ;Chen S;Shao ZM;Di GH
通讯作者：
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DOI：
10.3390/s120709936
发表时间：
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