Clinical value of nomogram model based on contrast-enhanced ultrasound for predicting human epidermal growth factor receptor 2 expression in breast cancer patients
Objective To construct a nomogram model based on contrast-enhanced ultrasound(CEUS)for predicting human epidermal growth factor receptor 2(HER-2)expression in breast cancer patients,and to explore its clinical application value.Methods A total of 79 cases of breast cancer diagnosed by pathological examination in our hospital were selected and divided into HER-2 positive group(42 cases)and HER-2 negative group(37 cases)according to the expression of HER-2,and the differences of CEUS examination results between the two groups were compared.Multivariate Logistics regression analysis was used to analyze the independent influencing factors for predicting HER-2 expression in breast cancer patients,and nomogram model was constructed.Receiver operating characteristic(ROC)curve was drawn,and area under the ROC curve and consistency index(C-index)were used to evaluate the differentiation of the model.Calibration curve was used to evaluate the calibration degree of the model.Decision curve was used to analyze the clinical applicability of the model.Results The proportion of filling defects and perforator vessels in HER-2 positive group were higher than those in HER-2 negative group,and the differences were statistically significant(both P<0.05).There were no significant difference in enhancement intensity,post-enhancement range and enhancement lesion margin between the two groups.The peak time(PT)in HER-2 positive group was lower than that in HER-2 negative group,the area under the curve(AUC)and the rising slope(K)were higher than those in HER-2 negative group,the difference were statistically significant(all P<0.05),and the peak intensity between the two groups was not statistically different.Multivariate Logistic regression analysis showed that perforator vessel,PT,AUC and K were independent influencing factors for predicting HER-2 expression in breast cancer patients(OR=22.015,0.381,1.629,4.010,all P<0.05).The C-index of HER-2 expression in breast cancer patients was 0.946 by constructing a nomogram model based on the independent influencing factors,the area under ROC curve was 0.946(95%confidence interval:0.897～0.996),the specificity was 84.62%,the sensitivity was 97.30%.Calibration curve showed that the absolute error of the prediction possibility of the nomogram model was 0.016.Decision curve analysis showed that when the threshold probability>17%,breast cancer patients might benefit the most after clinical intervention.Conclusion The nomogram model based on CEUS can effectively predict HER-2 expression in breast cancer patients.
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