首页|超声特征列线图模型在乳腺导管原位癌和导管内乳头状瘤鉴别诊断中的应用

超声特征列线图模型在乳腺导管原位癌和导管内乳头状瘤鉴别诊断中的应用

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目的:分析乳腺导管原位癌(DCIS)和导管内乳头状瘤(IDP)的临床及超声特征,构建DCIS与IDP的列线图预测模型.方法:选取经病理证实的156例(212个)DCIS和158例(238个)IDP的患者资料,经单因素和多因素分析评估超声诊断DCIS的影响因素,建立诊断模型,明确各超声征象在诊断中的价值.结果:单因素分析结果显示,两组在年龄、病史、结节长径、体积、边缘、后方回声、钙化、彩色多普勒血流成像(CDFI)及阻力指数(RI)等方面差异有统计学意义(P<0.05).多因素Logistic回归分析显示,结节周围导管无异常、后方回声衰减、出现微钙化及RI≥0.70时,倾向于DCIS;结节周围导管为单纯性扩张或乏血供时,倾向于IDP.将这些指标纳入列线图模型,在训练集和验证集中均显示出较高的预测性能、校准和临床价值.结论:超声特征列线图模型可以便捷鉴别DCIS和IDP,当结节周围导管无异常、后方回声衰减、出现微钙化、RI≥0.70时应警惕DCIS的发生.
Application of nomogram model based on sonographic fea-tures in the differential diagnosis of breast ductal carcinoma in situ and intraductal papilloma
Objective:To analyze the clinical and ultrasonographic characteristics of ductal carcinoma in situ(DCIS)and intraductal papilloma(IDP),and to construct a nomogram predictive model for DCIS and IDP.Methods:We selected data from 156 cases(212 nodules)of DCIS and 158 cases(238 nodules)of IDP confirmed by pathology.Through univariate and multivariate analy-ses,we evaluated the influencing factors of ultrasonic diagnosis of DCIS and established a diagnos-tic model to clarify the value of each ultrasonographic sign in diagnosis.Results:The univariate analysis showed statistically significant differences between the two groups in terms of age,medi-cal history,nodule long diameter,volume,margin,posterior echo,calcification,color Doppler flow imaging(CDFI),and resistance index(R/)(P<0.05).The multivariate logistic regression analysis showed that the absence of abnormal ducts around the nodule,posterior echo attenuation,pres-ence of microcalcifications,and RI≥0.70,tend to indicate DCIS,while simple dilation or lack of blood supply of the duct around the nodule tend to indicate IDP.These indicators were included in the nomogram model,which showed high predictive performance,calibration,and clinical value in both the training and validation sets.Conclusion:The nomogram model based on sonographic fea-tures can easily distinguish DCIS from IDP.The presence of abnormal ducts around the nodule,posterior echo attenuation,presence of microcalcifications,and RI>0.70 should raise suspicion for DCIS.

Breast neoplasmBreast ductal carcinoma in situ,intraductal papillomaUltrasound featuresNomogram

隆雨卿、吴海燕、李媛、周星辰、吴梅

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山东大学第二医院医学影像中心超声科(山东 济南 250033)

山东第一医科大学附属济南市中心医院 妇科(山东 济南 250013)

山东大学第二医院病理科(山东 济南 250033)

乳腺肿瘤 乳腺导管原位癌,导管内乳头状瘤 超声特征 列线图

2024

中国现代普通外科进展
山东大学

中国现代普通外科进展

CSTPCD
影响因子:0.993
ISSN:1009-9905
年,卷(期):2024.27(6)
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