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开发和验证一个包含YpT阶段的名图,用于使用临床结节阳性乳腺癌的多中心数据预测ypN0

Hideo Shigematsu¹, Shinsuke Sasada², Junji Hashizume³

¹Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3-Kasumi, Minami-ku, Hiroshima City, 734-8551, Japan. shigematu1330@hiroshima-u.ac.jp.

Scientific reports

|December 10, 2025

概括

一种新型的诺米图准确地预测了经过新辅助化疗 (NAC) 后乳腺癌患者的腹反应 (ypN0). 该工具有助于根据NAC后活检结果识别减少手术的候选人.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
诊断成像诊断成像诊断成像

背景情况:

在新辅助化疗 (NAC) 后,病理完整反应 (pCR) 对于预测乳腺癌结果至关重要.
通过图像导向活检对pCR进行准确的手术前诊断现在是可行的.
预测状淋巴结反应 (ypN0) 对于临床结节阳性 (cN+) 乳腺癌的治疗缓解至关重要.

研究的目的:

开发和外部验证用于预测 cN+ 乳腺癌患者的 ypN0 的名谱,这些患者接受 NAC.治疗.
用已确定的统计指标来评估名图的诊断性能.

主要方法:

对609名cN+乳腺癌患者进行了回顾性多中心研究,这些患者接受了NAC,随后进行了手术.
使用培训队列 (n=330) 开发名录,并在独立队列 (n=279) 中验证.
诺米图的预测因素包括ypT阶段,cN阶段,激素受体状态,HER2状态和NAC后cN阶段.

主要成果:

该名图表表现出强大的区分能力,偏差校正的AUC为0.858 (训练) 和0.855 (验证).
校准图和决策曲线分析证实了模型的良好性能.
积极的预测值 (PPV) 在两个队列中的预测概率≥0.7时超过0.90.

结论:

开发的诺米图准确地预测了cN+乳腺癌患者在NAC后的ypN0.
这种工具可能有助于根据NAC活检后的结果选择患者进行手术降级.
建议通过活检确认的pCR进行前性验证.

关键词:

乳腺癌乳腺癌乳腺癌新辅助化学疗法新辅助化学疗法这个名字叫做Nomogram.这就是YpN0的意思.在 YpT 阶段.

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