Predictive value of ultrasonographic features and immunohistochemical markers for pathological complete response of axillary lymph nodes after neoadjuvant therapy for breast cancer
Objective To investigate the predictive value of ultrasound features and immunohistochemical markers for axillary lymph node pathological complete response(pCR)after neoadjuvant therapy(NAT)for breast cancer.Methods The clinical data of 140 breast cancer patients with axillary lymph node metastasis(ALNM)admitted to Nantong Tumor Hospital from January 2020 to September 2023 were retrospectively analyzed.All patients underwent NAT+surgical resection+axillary lymph node dissection.According to the pathological results of axillary lymph nodes,the patients were divided into pCR group(n=53)and non-pCR group(n=87).The ultrasonic features and immunohistochemical markers of primary breast cancer and axillary lymph nodes before NAT were compared between the two groups.Logistic regression analysis was used to establish the independent predictors of pCR of axillary lymph nodes after NAT of breast cancer,and ROC curve was used to verify its predictive efficacy.Results There were significant differences in the aspect ratio of primary tumor,Adler blood flow grading,short diameter of axillary lymph nodes,ratio of long and short diameter,cortical and medullary boundary,morphology,CDFI blood flow signal,HER-2 and Ki-67 between the two groups(P<0.05).Logistic regression analysis showed that the ratio of long and short diameter of axillary lymph nodes≥2,axillary lymph node morphology type I-II,no CDFI blood flow signal in axillary lymph nodes,HER-2 positive and Ki-67 high expression were independent predictors of pCR of axillary lymph nodes after NAT in breast cancer(P<0.05).ROC curve showed that the combined diagnosis had the highest predictive efficiency,with AUC of 0.739(95%CI 0.643-0.812),sensitivity of 68.42%and specificity of 75.34%.Conclusion Ultrasound features and immunohistochemical markers have certain predictive value for pCR of axillary lymph nodes after NAT in breast cancer.
breast canceraxillary lymph node metastasisneoadjuvant chemotherapyultrasoundimmunohistochemistry
万方数据
维普
