|Table of Contents|

Establishment of a comprehensive prediction model for axillary lymph node metastasis after neoadjuvant chemotherapy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2020 01
Page:
53-57
Research Field:
Publishing date:

Info

Title:
Establishment of a comprehensive prediction model for axillary lymph node metastasis after neoadjuvant chemotherapy
Author(s):
Fang YihanZhao Yi
Department of Breast Surgery,Shengjing Hospital of China Medical University,Liaoning Shenyang 110004,China.
Keywords:
neoadjuvant chemotherapy for breast cancersentinel lymph node biopsyaxillary lymph node metastasisnomogram
PACS:
R737.9
DOI:
10.3969/j.issn.1672-4992.2020.01.013
Abstract:
Objective:To establish a comprehensive prediction model of lymph node metastasis after neoadjuvant chemotherapy for breast cancer,evaluate the situation of lymph node metastasis after neoadjuvant chemotherapy,and guide the selection of clinical operation plan.Methods:The clinical and imaging data of 143 patients with neoadjuvant chemotherapy for breast cancer from January 2015 to December 2018 were retrospectively analyzed,and the patients were divided into metastatic group and non-metastatic group according to postoperative lymph node pathology.Univariate analysis was performed by chi-square test and t-test.Indicators with P<0.05 were included in multivariate Logistic regression analysis.The nomogram of the comprehensive prediction model of lymph node metastasis after neoadjuvant chemotherapy for breast cancer was constructed by multi-factor analysis with statistically significant indexes(P<0.05),and the ROC curve was applied to evaluate the performance of the model.Results:Univariate analysis showed that chemotherapy regimen,lymph node biopsy before chemotherapy,preoperative physical examination,preoperative color doppler ultrasound,preoperative CT/MRI,and RECIST grading have predictive effects on axillary lymph node metastasis.Multivariate analysis showed that pathology,preoperative color doppler ultrasound and RECIST grading are independent predictors of axillary lymph node metastasis after neoadjuvant chemotherapy.The area under the curve,specificity and sensitivity of the predictive model of lymph node metastasis after neoadjuvant chemotherapy for breast cancer were 0.785,85.4% and 59.8% respectively.Conclusion:The comprehensive prediction model of lymph node metastasis after neoadjuvant chemotherapy for breast cancer has a good prediction ability for axillary lymph node metastasis and can provide clinical guidance for the selection of appropriate surgical methods.

References:

[1]Liu SZ.The effect of complete remission of axillary lymph node pathology after neoadjuvant chemotherapy on the prognosis of breast cancer[J].Chinese Journal of Modern Drug Application,2018,12(12):26-27.
[2]LUO ZB,YE YQ,CHEN LW,et al.Comparison of sentinel lymph node biopsy results before and after neoadjuvant chemotherapy in patients with clinically staged CT2,3N0M0 breast cancer[J].Guangdong Medical Journal,2014,35(18):2877-2879.[罗忠兵,叶永强,陈露文,等.临床分期CT2,3N0M0乳腺癌患者新辅助化疗前后前哨淋巴结活检结果比较[J].广东医学,2014,35(18):2877-2879.]
[3]Juan XU,Xinhong WU,Yaojun FENG.The clinical significance of axillary sentinel lymph node biopsy in different clinical stages breast cancer patients after neoadjuvant chemotherapy[J].Chinese-German J Clin Oncol,2013,12(11):521-523.
[4]YU Y,JIA SL,SHENG Y.Feasibility of sentinel lymph node biopsy in breast cancer patients following neoadjuvant chemotherapy:A systematic analysis[J].Academic Journal of Second Military Medical University,2016,37(1):120-126.[于跃,贾淞淋,盛媛.乳腺癌患者新辅助化疗后行前哨淋巴结活检可行性的系统评价[J].第二军医大学学报,2016,37(1):120-126.]
[5]MO HB.Study on false negative rate of sentinel lymph node biopsy and response to neoadjuvant chemotherapy in metastatic lymph nodes of breast cancer[D].Chongqing:Master’s Thesis of the Third Military Medical University,2017.[莫红彪.乳腺癌前哨淋巴结活检术假阴性及转移淋巴结新辅助化疗反应的研究[D].重庆:第三军医大学硕士学位论文,2017.]
[6]Tee SR,Devane LA,Evoy D.Meta-analysis of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy-proven node-positive breast cancer[J].Br J Surg,2018,105(12):1541-1552.
[7]WEI J,WANG C,XIE XX,et al.Analysis of the effect of neoadjuvant chemotherapy on sentinel lymph node biopsy in breast cancer[J].Modern Instruments & Medical Treatment,2018,24(6):96-98.[韦军,王聪,谢贤鑫,等.乳腺癌新辅助化疗对前哨淋巴结活检影响分析[J].现代仪器与医疗,2018,24(6):96-98.]
[8]LI M,HUANG Z,LI XY,et al.Feasibility of sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer[J].China Modern Medicine,2018,25(20):63-65.[李敏,黄湛,李晓勇,等.乳腺癌新辅助化疗后前哨淋巴结活检的可行性研究[J].中国当代医药,2018,25(20):63-65.]
[9]CHEN J,CAO YL,WU XB.Clinical significance of breast cancer molecular typing in sentinel lymph node biopsy after chemotherapy for breast cancer[J].Chin J Gerontol,2017,37(19):4887-4889.[陈军,曹亚丽,吴晓波.乳腺癌分子分型在乳腺癌化疗后前哨淋巴结活检中的临床意义[J].中国老年学杂志,2017,37(19):4887-4889.]
[10]LU YJ,XIE L.Study on sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer[J].Journal of Aerospace Medicine,2018,29(6):680-681.[陆咏江,谢磊.乳腺癌新辅助化疗后前哨淋巴结活检术的研究[J].航空航天医学杂志,2018,29(6):680-681.]
[11]HOU ZG,ZHU FY.Feasibility study of sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer[J].China Modern Doctor,2018,56(16):8-11.[侯志刚,朱福义.乳腺癌新辅助化疗后行前哨淋巴结活检的可行性研究[J].中国现代医生,2018,56(16):8-11.]
[12]Choi HJ,Kim I,Alsharif E.Use of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with axillary node-positive breast cancer in diagnosis[J].J Breast Cancer,2018,21(4):433-441.
[13]QIN L,WANG JJ,ZHANG CJ,et al.The significance of sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer[J].Chin J Gerontol,2014,8(34):2085-2086.[秦丽,王俊杰,张崇建,等.乳腺癌新辅助化疗后前哨淋巴结活检的意义[J].中国老年学杂志,2014,8(34):2085-2086.]
[14]ZHANG B,XU B,LIU ZJ,et al.Analysis of the factors affecting pathologic complete response of axillary lymph nodes after neoadjuvant chemotherapy[J].Henan Medical Research,2017,26(8):1353-1356.[张博,徐斌,刘朝俊,等.新辅助化疗后腋窝淋巴结病理完全缓解的影响因素分析[J].河南医学研究,2017,26(8):1353-1356.]
[15]Kim WH,Kim HJ,Park HY,et al.Axillary pathologic complete response to neoadjuvant chemotherapy in clinically node-positive breast cancer patients:a predictive model integrating the imaging characteristics of ultrasound restaging with known clinicopathologic characteristics[J].Ultrasound Med Biol,2019,45(3):702-709.
[16]Murphy BL,L Hoskin T,Heins CDN,et al.Preoperative prediction of node-negative disease after neoadjuvant chemotherapy in patients presenting with node-negative or node-positive breast cancer[J].Ann Surg Oncol,2017,24(9):2518-2525.
[17]D Tamayo Carabao,R lvarez Pérez, DE Bonilla Damiá,et al.Sentinel lymph node biopsy in N+ breast cancer with conversion into N0 after neoadjuvant chemotherapy[J].Rev Esp Med Nucl Imagen Mol,2018,26(18):30161-30164.
[18]Kim JY,Park HS,Kim S,et al.Prognostic nomogram for prediction of axillary pathologic complete response after neoadjuvant chemotherapy in cytologically proven node-positive breast cancer[J].Medicine(Baltimore),2015,94(43):e1720.
[19]LE J,ZHOU SC,FAN YW,et al.The value of the conventional ultrasound for the assessment of axillaries in patients with breast cancer after neoadjuvant chemotherapy[J].Chinese Journal of Medical Ultrasound(Electronic Edition),2016,13(7):538-541.[乐坚,周世崇,范亦武,等.新辅助化疗后乳腺癌腋下淋巴结的超声影像分析[J].中华医学超声杂志(电子版),2016,13(7):538-541.]
[20]Boughe YJC,Ballman KV,Hunt KK,et al.Axillary ultrasound after neoadjuvant chemotherapy and its impact on sentinel lymph node surgery:Results from the American College of Surgeons Oncology Group Z1071 Trial(Alliance)[J].J Clin Oncol,2015,33(30):3386-3393.
[21]LI F,ZENG J,LI CY,et al.MRI evaluation of axillary lymph nodes after neoadjuvant chemotherapy for breast cancer[J].Tianjin Medical Journal,2016,44(1):94-97.[李富,曾健,李春燕,等.MRI对乳腺癌新辅助化疗后腋窝淋巴结的评估[J].天津医药,2016,44(1):94-97.]
[22]ZHANG H,LIN MB,WANG JS,et al.Effect of neoadjuvant chemotherapy on sentinel lymph node in breast cancer patients[J].Surgical Research and New Technique,2017,6(4):235-238,245.[张辉,林孟波,王金泗,等.新辅助化疗对乳腺癌腋窝前哨淋巴结状况的影响[J].外科研究与新技术,2017,6(4):235-238,245.]
[23]JIA S,XUE JQ,ZHANG WH,et al.Preoperative evaluation of axillary lymph node in breast cancer[J].Journal of Endocrine Surgery,2015,9(2):93-96.[贾实,薛今琦,张文海,等.乳腺癌腋窝淋巴结的术前评估[J].中华内分泌外科杂志,2015,9(2):93-96.]

Memo

Memo:
辽宁省自然科学基金(编号:2015020544)
Last Update: 1900-01-01