Objective To construct a risk model using dual-mode ultrasound to identify breast cancer patients with a high lymph node metastasis load.This model provides references for the formulation of surgical protocols.Methods The study included 168 breast cancer patients who underwent surgical treatment at Huzhou Central Hospital between May 2021 and May 2023.Preoperative dual-mode ultrasonography was performed and the patients were divided into two groups based on the status of lymph node metastasis:high metastatic load group(62 cases,≥ 3 metastatic lymph nodes)and low metastatic load group(106 cases,≤2 metastatic lymph nodes).LASSO-logistic regression was used to screen varia-bles and construct a prediction model for preoperative high metastatic load of lymph nodes in breast cancer patients based on dual-mode ultrasound.The effectiveness of the model was also verified.Results Four representative characteristics,namely vascular invasion,catheter dilation,Adler blood flow grading and elastic strain rate were selected through LASSO regression analysis with 10-fold cross-validation.Multivariate logistic analysis revealed that vascular invasion(OR=2.250,95％CI 1.012-5.002),Adler blood flow grade Ⅱ/Ⅲ(OR=2.929,95％CI:1.256-6.827),catheter dila-tion(OR=2.548,95％CI:1.066-6.093)and high elastic strain rate(OR=4.167,95％CI:2.486-6.982)were i-dentified as risk factors for preoperative high burden of lymph node metastasis in breast cancer patients(P＜0.05).The C-index for factors predicting preoperative high metastatic load of lymph nodes in breast cancer patients was 0.834(95％CI:0.771-0.898),and the calibration curve demonstrated good agreement between measured and predicted val-ues.Conclusion The model constructed using conventional two-dimensional ultrasound and shear-wave elastography ul-trasound images combines the characteristics of multiple modes to make their information complementary.This is helpful in improving the accuracy of qualitative and localization analysis of lymph node metastasis load before breast cancer.
Breast cancerTwo-mode ultrasoundLymph nodesTransfer loadPrediction model
维普
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