Value of mammographic features,ADC value and serum CA125,CEA levels in predicting the pathological status of axillary lymph nodes after neoadjuvant chemotherapy in breast cancer
Objective:To investigate the value of combining mammographic features,apparent diffusion coefficient(ADC)value,and serum CA125,CEA levels in predicting the pathological status of metastatic axillary lymph nodes after neoadjuvant chemotherapy in breast cancer.Methods:A total of 152 female patients with breast cancer who received neoadjuvant chemotherapy and axillary lymph node dissection in our hospital from January 2020 to December 2022 were prospectively included.Ac-cording to the pathological results after axillary lymph node dissection,all patients were divided into the axillary pathological complete response(PCR)group(55 cases)and the non-PCR group(97 ca-ses).Within one week before neoadjuvant chemotherapy,all patients underwent mammography,diffu-sion-weighted magnetic resonance imaging,and serum CA125 and CEA level testing.Results:There were significant differences in Ki-67 expression between axillary PCR and non-PCR patients after neo-adjuvant chemotherapy(P＜0.05).The incidence of increased vascularity,thickened vessels,and spicu-lated margins in the mammographic findings of non-PCR axillary patients after neoadjuvant chemo-therapy were significantly higher than that of PCR patients before treatment(P＜0.05).After neoad-juvant chemotherapy,the ADC value in non-PCR patients was significantly lower than that of PCR pa-tients before treatment(t=4.372,P＜0.001),while serum CA125 and CEA levels were significantly higher than those of PCR patients(P＜0.05).Multivariate logistic regression analysis showed that Ki-67 high expression(X1),increased vascularity and thickened vessels(X2),higher ADC value(X4),and serum CA125 level(X5)were independent risk factors for non-PCR after neoadjuvant chemother-apy in breast cancer patients(P＜0.05).The constructed logistic regression model was as follows:Logit(P)=-3.206+0.792X1+0.953X2+1.199X4+0.845X5.ROC curve analysis showed that the ar-ea under the curve for predicting the pathological status of metastatic axillary lymph nodes after neo-adjuvant chemotherapy was 0.856(95％CI:0.794～0.917),with a sensitivity and specificity of 73.2％and 85.5％,respectively.Conclusion:The mammogram features,ADC value,serum CA125 level,and Ki-67 expression status are associated with the pathological status of axillary lymph nodes after neoad-juvant chemotherapy in breast cancer patients with metastatic axillary lymph nodes,and the combina-tion of these features has certain predictive value.
Breast cancerAxillary lymph node metastasisMolybdenum target X-rayAp-parent diffusion coefficientCA125CEANeoadjuvant chemotherapy
维普
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