The value of mammogram and MRI parameters combined with peripheral blood RLR in predicting recurrence and metastasis after modified radical breast cancer surgery
10.3760/cma.j.cn115807-20240410-00107
- VernacularTitle:乳腺X线和MRI参数联合外周血RLR水平预测乳腺癌改良根治术后复发转移的价值
- Author:
Jiangang YE
1
;
Junwen PENG
;
Li LI
Author Information
1. 浙江大学医学院附属二院建德分院 建德市第一人民医院放射科，建德 311600
- Keywords:
Breast cancer;
Recurrence and metastasis;
Mammogram;
Apparent diffusion coefficient;
Red blood cell distribution width and lymphocyte ratio
- From:
Chinese Journal of Endocrine Surgery
2024;18(3):404-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of mammography and MRI parameters combined with red cell distribution width to lymphocyte ratio (RLR) in predicting recurrence and metastasis of breast cancer after modified radical surgery.Methods:104 female breast cancer patients who received improved radical surgery in Jiande First People’s Hospital from Jun. 2021 to Dec. 2023 were included as the study objects. The Japanese MGU-1000D MAMMOREX Pe.ru.ru DIGITAL mammography machine was used to examine each subject before surgery, and the X-ray signs of the primary tumor lesion were recorded, including maximum diameter, breast density, calcification, mass morphology, vascular signs and tumor margin. The primary tumor was evaluated by MRI using a MAGNETOM Verio magnetic resonance imaging machine and a dedicated breast examination coil, the apparent diffusion coefficient (ADC) value was measured and automatically calculated, and the RLR was recorded.Results:There were 31 patients with recurrence and metastasis and 73 patients without recurrence or metastasis. The proportion of patients with clinical stage III and Ki67 level > 14% in postoperative recurrence and metastasis group was significantly higher than that in patients without recurrence and metastasis. The proportion of patients with calcification, vascular thickening, increase and burr at the edge of mass in the recurrence and metastasis group was significantly higher than that in the patients without recurrence or metastasis. The ADC value of patients with recurrence and metastasis after breast cancer surgery was 0.93±0.12, and that of patients without recurrence and metastasis was 1.08±0.15, the former was significantly lower than the latter, and the difference was statistically significant ( t=5.64, P<0.001). The RLR of peripheral blood in patients with recurrence and metastasis after breast cancer surgery was 21.36±2.39, and that of patients without recurrence and metastasis was 19.93±2.14, the former was significantly higher than the latter, and the difference was statistically significant ( t=4.37, P<0.001). Multivariate Logistic regression analysis showed that axillary lymph node metastasis, vascularization, thickening, burr on tumor edge, small ADC value and large peripheral blood RLR were independent risk factors for recurrence and metastasis after breast cancer surgery ( P<0.05). ROC curve results showed that the area under the curve of the logistic regression model based on the above factors was 0.860 (0.798-0.921), the sensitivity was 80.4%, and the specificity was 81.8%. Conclusion:Mammogram and MRI parameters combined with peripheral blood RLR level have certain value in predicting recurrence and metastasis after modified radical breast cancer surgery.
