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目的：构建基于多模式磁共振检查特征的浸润性乳腺癌伴腋窝淋巴结转移风险预测模型，并评估其预测效能，旨在为早期准确识别需行术中淋巴结活检的患者及指导后续诊疗方案制定提供依据。方法：回顾性纳入141例经手术治疗并病理确诊的浸润性乳腺癌患者，根据术后是否伴腋窝淋巴结转移分组。采用单因素和多因素分析法评估腋窝淋巴结转移的独立危险因素，构建回归预测模型。结果：单因素分析显示，脉管神经侵犯、Ki-67表达水平、病灶边缘特征、病灶内部强化形式及表观弥散系数与腋窝淋巴结转移相关（P<0.05）。多因素Logistic回归分析表明，早期快速强化、病灶不均匀或环形强化及更低表观弥散系数是独立危险因素（P<0.05）。ROC曲线分析显示，回归模型预测概率的AUC为0.90，高于单一指标的AUC。结论：浸润性乳腺癌患者腋窝淋巴结转移与多模式磁共振检查特征密切相关，基于这些特征的预测模型在风险预测中表现优异。
Abstract：Objective: To construct the prediction model for axillary lymph node metastasis risk in patients with invasive breast cancer based on multimodal magnetic resonance imaging features and evaluate its prediction performance, aiming to provide evidence for early and accurate identification of patients requiring intraoperative lymph node biopsy and guidance for subsequent diagnosis and treatment planning. Methods: A retrospective study included 141 patients with invasive breast cancer confirmed by surgical pathology.Patients were grouped according to the presence of axillary lymph node metastasis after surgery. Univariate and multivariate analyses were conducted to identify independent risk factors for axillary lymph node metastasis, and a regression prediction model was constructed. Results: Univariate analysis revealed that vascular nerve invasion, Ki-67 expression level, lesion edge features, internal enhancement pattern, and apparent diffusion coefficient were associated with axillary lymph node metastasis(P<0.05). Multivariate Logistic regression analysis showed that early rapid enhancement, uneven or circular enhancement, and lower apparent diffusion coefficient were independent risk factors(P<0.05). ROC curve analysis demonstrated that the AUC of the regression model prediction probability was 0.90, higher than that of single indicators. Conclusion: There is a close correlation between multimodal MRI features,including early enhancement, internal enhancement, and apparent diffusion coefficient, and axillary lymph node metastasis in patients with invasive breast cancer. The prediction model based on these features exhibits superior performance in predicting axillary lymph node metastasis risk.
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基本信息:
中图分类号:R737.9;R445.2
引用信息:
[1]江铸,陈竹碧,袁琳,等.基于多模式磁共振检查特征的浸润性乳腺癌伴腋窝淋巴结转移风险预测模型构建[J].影像科学与光化学,2026,44(02):91-96+106.
基金信息:
四川省医学会专项科研项目（SC202403）; 宜宾市科技计划项目（2023SF008）
2024-12-19
2024
2025-04-01
2025
2
2026-03-04
2026-03-04