Diagnostic value of four types of breast BI-RADS nodules by constructing a nomogram based on multi-modal ultrasound features combined with inflammatory complex indicators
10.3760/cma.j.cn115807-20240423-00132
- VernacularTitle:基于多模态超声特征联合炎性复合指标构建列线图对乳腺BI-RADS 4类结节的诊断价值
- Author:
Xiaoxia HOU
1
;
Jingshu GUO
;
Xiaoyuan CHEN
Author Information
1. 西北妇女儿童医院医学超声中心，西安 710006
- Publication Type:Journal Article
- Keywords:
Breast cancer;
Breast imaging reporting and data system;
Multimode ultrasound;
Neutrophil to lymphocyte ratio;
Systemic inflammatory response index
- From:
Chinese Journal of Endocrine Surgery
2024;18(6):859-864
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic value of the nomogram constructed based on multi-modal ultrasound features combined with inflammatory complex indicators for benign and malignant nodules in breast imaging reporting and data system (BI-RADS) .Methods:102 female patients with breast BI-RADS type 4 nodules who were treated in Northwest Women’s and Children’s Hospital from Jan. 2021 to Mar. 2024 were included as study objects, and benign and malignant nodules were determined according to postoperative pathological examination results. Conventional ultrasound, shear-wave elastography and contrax-ultrasound were performed in each breast BI-RADS patient with Class 4 nodules using Mindray resona7 ultrasonic diagnostic instrument within 1 week before surgery to record the ultrasonic characteristics. According to the results of laboratory examination, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (NLR), PLR, the systemic immune inflammation index (SII), and the systemic inflammatory response index (SIRI) were calculated and recorded.Results:There were 42 cases of malignant nodules and 60 cases of benign nodules. Compared with the benign group, there were significant differences in nodule boundary, internal echo, Alder blood flow grading, hard ring sign, area expansion after enhancement, peripheral radial enhancement and perfusion defect in the malignant group ( χ2 value was 5.83, 9.31, 5.20, 10.25, 6.99, 7.24, 4.90, P < 0.05). Compared with the benign group, NLR and SIRI in the malignant group were significantly increased, with statistical difference (t-value 3.13 and 4.33, P < 0.05). The results of multi-factor Logistics regression analysis show that breast BI-RADS were characterized by blurred nodule boundary (X1), Alder blood flow grade 2-3 (X3), hard ring sign (X4), enlarged area after enhancement (X5), peripheral radial enhancement (X6), NLR≥2.29 (X8), SIRI≥0.91 (X9) were independent risk factors for malignant nodules ( P < 0.05). Based on these factors, the Logistics regression model was established as Logit (P) = -3.217 + 0.291X1 + 1.051X3 + 0.354X4 + 0.360X5 + 0.524X6 + 0.513X8 + 0.726X9. The results of calibration curve and clinical decision curve evaluation showed that the model had good accuracy and high predictive value. ROC curve analysis results showed that the area under the curve of the nomogram model for predicting benign and malignant nodules of category 4 breast BI-RADS was 0.925 (0.877-0.974), the sensitivity was 88.6%, and the specificity was 86.1%. Conclusion:The nomogram model constructed by multi-modal ultrasound combined with inflammatory complex index NLR and SIRI has certain application value in the differential diagnosis of benign and malignant breast BI-RADS 4 nodules.
