Objective To construct a nomogram model based on the pathological and ultrasound image features of the primary lesions of invasive breast cancer,and to investigate its clinical value in predicting axillary lymph node metastasis.Methods A total of 369 female patients with pathologically confirmed invasive breast cancer were retrospectively analyzed,and were randomly divided into the training set(n=258)and verification set(n=111)at a ratio of 7∶3.The patients in the training set were divided into metastatic group(n=116)and non-metastatic group(n=143)according to whether axillary lymph node metastasis occurred.The differences of serum tumor marker,pathological and ultrasound image features between the two groups were compared.Binary Logistic regression analysis was used to screen the independent influencing factors for predicting axillary lymph node metastasis in patients with invasive breast cancer,and a nomogram model for predicting axillary lymph node metastasis was constructed.Receiver operating characteristic(ROC)curve and calibration curve were drawn to evaluate the discrimination and calibration,respectively.Results The differences in pathological type,histological grade,serum tumor marker(carbohydrate antigen 153 and carcinoembryonic antigen)levels,ultrasound image features(maximum diameter,location and presence or absence of hyperechoic halo)between metastatic group and non-metastatic group in the training set were statistically significant(all P<0.05).Binary Logistic regression analysis showed that the location of the primary lesions(inner lower quadrant),hyperechoic halo,maximum diameter and histological grade were independent influencing factors in predicting axillary lymph node metastasis in patients with invasive breast cancer(OR=0.064,13.278,1.049,9.277,all P<0.05).The area under ROC curve of the constructed nomogram model for predicting axillary lymph node metastasis in the training set and verfication set were 0.845 and 0.823,respectively.The calibration curve was highly consistent with the ideal curve,and the nomogram model had good discrimination and calibration.Conclusion The nomogram model based on the pathological and ultrasound image features of the primary invasive breast cancer can effectively predict the risk of axillary lymph node metastasis,and provide reference for accurate diagnosis and treatment.
UltrasonographyPathologyInvasive breast cancerAxillary lymph node metastasisNomogram
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