临床医学
臨床醫學
림상의학
CLINICAL MEDICINE
2015年
6期
1-3
,共3页
乳腺癌%淋巴结转移%免疫组化%风险因素%Logistic 回归%ROC 分析
乳腺癌%淋巴結轉移%免疫組化%風險因素%Logistic 迴歸%ROC 分析
유선암%림파결전이%면역조화%풍험인소%Logistic 회귀%ROC 분석
Breast cancer%Lymphatic metastasis%Immunohistochemistry%Risk factor%Logistic regression%ROC analysis
目的：分析和筛选乳腺癌淋巴结转移患者的免疫组化和超声影像学相关危险因素，建立相关数学模型并进行初步评价。方法回顾性收集2009年至2012年度乳腺癌患者的相关信息，采用单因素和多因素的非条件 Logistic 回归方法对8个淋巴结转移相关风险因素进行分析，筛选出具有统计学意义的影响因素，并建立相应的数学模型，采用 ROC分析方法对所建立的模型进行评价。结果共纳入1025例患者。对8个相关因素的单因素分析结果显示，Her-2、Ki67、p53、彩超结果中肿块大小和有无腋窝淋巴结肿大5个因素差异有统计学意义。将该5个因素引入多因素非条件 Logistic回归分析，筛选出 Her-2、Ki67、肿块大小和有无腋窝淋巴结肿大4个相关危险因素。同时根据所筛选的因素建立数学诊断模型，采用 ROC 方法进行评价，结果显示所建立的模型能提高诊断的敏感性和特异性。结论4个危险因素为乳腺癌淋巴结转移的相关因素，且为高风险因素，对辅助诊断乳腺癌淋巴结转移具有一定的价值。
目的：分析和篩選乳腺癌淋巴結轉移患者的免疫組化和超聲影像學相關危險因素，建立相關數學模型併進行初步評價。方法迴顧性收集2009年至2012年度乳腺癌患者的相關信息，採用單因素和多因素的非條件 Logistic 迴歸方法對8箇淋巴結轉移相關風險因素進行分析，篩選齣具有統計學意義的影響因素，併建立相應的數學模型，採用 ROC分析方法對所建立的模型進行評價。結果共納入1025例患者。對8箇相關因素的單因素分析結果顯示，Her-2、Ki67、p53、綵超結果中腫塊大小和有無腋窩淋巴結腫大5箇因素差異有統計學意義。將該5箇因素引入多因素非條件 Logistic迴歸分析，篩選齣 Her-2、Ki67、腫塊大小和有無腋窩淋巴結腫大4箇相關危險因素。同時根據所篩選的因素建立數學診斷模型，採用 ROC 方法進行評價，結果顯示所建立的模型能提高診斷的敏感性和特異性。結論4箇危險因素為乳腺癌淋巴結轉移的相關因素，且為高風險因素，對輔助診斷乳腺癌淋巴結轉移具有一定的價值。
목적：분석화사선유선암림파결전이환자적면역조화화초성영상학상관위험인소，건립상관수학모형병진행초보평개。방법회고성수집2009년지2012년도유선암환자적상관신식，채용단인소화다인소적비조건 Logistic 회귀방법대8개림파결전이상관풍험인소진행분석，사선출구유통계학의의적영향인소，병건립상응적수학모형，채용 ROC분석방법대소건립적모형진행평개。결과공납입1025례환자。대8개상관인소적단인소분석결과현시，Her-2、Ki67、p53、채초결과중종괴대소화유무액와림파결종대5개인소차이유통계학의의。장해5개인소인입다인소비조건 Logistic회귀분석，사선출 Her-2、Ki67、종괴대소화유무액와림파결종대4개상관위험인소。동시근거소사선적인소건립수학진단모형，채용 ROC 방법진행평개，결과현시소건립적모형능제고진단적민감성화특이성。결론4개위험인소위유선암림파결전이적상관인소，차위고풍험인소，대보조진단유선암림파결전이구유일정적개치。
Objective To analyze and screen the risk factors of both immunohistochemistry and ultrasound for axillary lymphat-ic metastasis of breast cancer,and to build a mathematical model for preliminary evaluation. Methods By conducting retrospective studies,the information of breast cancer patients from 2009 to 2012 were collected. Both single and multiple unconditional Logistic regression analysis were applied to screen 8 possible factors for lymphatic metastasis. After the factors with statistical significance were selected,the relevant mathematical model was built and then was evaluated by means of receiver operating characteristic (ROC)analysis. Results A total of 1025 patients were included. The single analysis on 8 possible factors showed significant differences in the following 5 factors:Her-2,p53,Ki67,the size of primary node and auxiliary lymph node. The multiple factors unconditional Logistic regression analyses on those 5 risk factors screened 4 relevant factors:Her-2,p53,Ki67,the size of primary node and the size of primary node and auxiliary lymph node. Then a mathematical diagnostic model was established based on the 4 identified risk factors,and the result of ROC analysis showed it could improve the diagnostic sensitivity and specificity compared with the single factor mathematical diagnostic model. Conclusion The 4 factors are related with breast cancer axillary lymphatic metastasis,and all of them are risk factors which have higher adjuvant diagnostic value for axillary lymphatic metastasis.
