乳腺癌腋窝淋巴结转移预测

发布时间：2018-04-25 19:33

本文选题：乳腺癌 + 腋窝淋巴结转移　；参考：《浙江大学》2017年硕士论文

【摘要】：目的:回顾性分析乳腺癌患者术前查体、超声检查、肿瘤阳性显像、粗针穿刺活检、术后常规病理、免疫组化结果等因素与腋窝淋巴结转移的相关性,并构建针对与所采用病例同样人群的乳腺癌腋窝转移预测模型。方法:对本院434例乳腺癌患者进行数据采集,对年龄、乳腺癌肿块部位(左右)、肿块查体象限、大小、活动度、质地、与皮肤是否可及粘连、腋窝查体淋巴结大小、质地、是否融合、超声报告肿块大小、象限、血流信号、钙化、边界、BI-RADS分类、腋窝淋巴结评估、大小、边界、是否融合、可疑淋巴结皮质厚度、血流信号、穿刺病理肿瘤组织学类型、免疫组化雌激素受体(ER)表达、孕激素受体(PR)表达、细胞增殖核抗原(Ki-67)、人类表皮生长因子受体2(Her-2)及CerbB-2的荧光原位杂交(FISH)、术后病理肿瘤组织学类型、组织学分级(WHO)、肿瘤大小、多灶性、淋巴管、脉管、皮肤、神经、肌肉侵犯、以及肿块及腋窝转移淋巴结的免疫组化结果、肿瘤分子分型,通过单因素分析描述其与乳腺癌腋窝转移相关性,筛选并行多因素Logistic分析其预测价值,建构针对我国病患的乳腺癌腋窝淋巴结转移模型。结果:筛选出超声肿块大小分层、术后病理诊断、PR状态、乳头受累、血管侵犯进入回归方程,其OR值分别为1.379、1.756、2.658、6.884、4.277,并得出乳腺癌腋窝淋巴结转移预测模型回归方程Logit(P)=-5.167+0.321*F1+0.563*F2+0.978*F3+1.929*F4+1.453*F5。结论:超声肿块大小分层、术后病理诊断、PR状态、乳头受累、血管侵犯是乳腺癌腋窝淋巴结转移的独立预测因素。
[Abstract]:Objective: To review the retrospective analysis of preoperative examination, ultrasonography, tumor positive imaging, rough needle biopsy, routine pathology, immunohistochemical results and other factors of axillary lymph node metastasis, and to construct a prediction model for the axillary metastasis of breast cancer in the same population as the cases used. Method: 434 cases of breast cancer in our hospital. Data collection, age, breast cancer mass site (left and right), mass, size, activity, texture, and skin adhesion, the size, texture, or fusion of the axillary lymph nodes, the size of the mass, the quadrant, the blood flow signal, the boundary, the BI-RADS classification, the axillary lymph node assessment, size, boundary, or not. Fusion, suspicious lymph node cortical thickness, blood flow signal, histologic type of pathological tumor, immunohistochemical estrogen receptor (ER) expression, progesterone receptor (PR) expression, cell proliferating nuclear antigen (Ki-67), human epidermal growth factor receptor 2 (Her-2) and CerbB-2 fluorescence in situ hybridization (FISH), histologic type and histological grade of postoperative pathological and tumor tumor Grade (WHO), tumor size, multifocal, lymphatic vessels, vasculature, skin, nerve, muscle invasion, and immunohistochemical results of tumor and axillary metastases, tumor molecular typing, and a single factor analysis of the correlation with breast cancer axillary metastasis, screening parallel multiple factor Logistic analysis for its predictive value and constructing milk for patients in China. Model of axillary lymph node metastasis of adenocarcinoma. Results: the size and stratification of ultrasonic mass, pathological diagnosis after operation, PR status, nipple involvement, and vascular invasion into the regression equation, the OR value was 1.379,1.756,2.658,6.884,4.277, and the regression equation of the prediction model of axillary lymph node metastasis of breast cancer was obtained, Logit (P) =-5.167+0.321*F1+0.563*F2+0.978*F3 +1.929*F4+1.453*F5. conclusion: the size and stratification of ultrasonic masses, postoperative pathological diagnosis, PR status, nipple involvement, and vascular invasion are independent predictors of axillary lymph node metastasis in breast cancer.

【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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