3D reconstruction based novel methods are more effective than traditional clinical assessment in breast cancer axillary lymph node metastasis prediction

作者全名："Qu, Limeng; Chen, Qitong; Luo, Na; Zhao, Piao; Zou, Qiongyan; Mei, Xilong; Liu, Ziru; Yi, Wenjun"

作者地址："[Qu, Limeng; Chen, Qitong; Luo, Na; Zou, Qiongyan; Liu, Ziru; Yi, Wenjun] Cent South Univ, Dept Gen Surg, Xiangya Hosp 2, 139 Renmin Cent Rd, Changsha 410011, Peoples R China; [Zhao, Piao] Chongqing Med Univ, Dept Orthopaed, Affiliated Hosp 1, Chongqing, Peoples R China; [Mei, Xilong] Cent South Univ, Dept Radiol, Xiangya Hosp 2, Changsha, Peoples R China; [Luo, Na] First Peoples Hosp Changde City, Dept Gen Surg, Changde, Peoples R China"

通信作者："Liu, ZR; Yi, WJ (通讯作者)，Cent South Univ, Dept Gen Surg, Xiangya Hosp 2, 139 Renmin Cent Rd, Changsha 410011, Peoples R China."

来源：SCIENTIFIC REPORTS

ESI学科分类：Multidisciplinary

WOS号：WOS:000828314800019

JCR分区：Q2

影响因子：4.6

年份：2022

卷号：12

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：　

摘要："The status of axillary lymph node metastases determines the treatment and overall survival of breast cancer (BC) patients. Three-dimensional (3D) assessment methods have advantages for spatial localization and are more responsive to morphological changes in lymph nodes than two-dimensional (2D) assessment methods, and we speculate that methods developed using 3D reconstruction systems have high diagnostic efficacy. This exploratory study included 43 patients with histologically confirmed BC diagnosed at Second Xiangya Hospital of Central South University between July 2017 and August 2020, all of whom underwent preoperative CT scans. Patients were divided into a training cohort to train the model and a validation cohort to validate the model. A 3D axillary lymph node atlas was constructed on a 3D reconstruction system to create various methods of assessing lymph node metastases for a comparison of diagnostic efficacy. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic values of these methods. A total of 43 patients (mean [SD] age, 47 [10] years) met the eligibility criteria and completed 3D reconstruction. An axillary lymph node atlas was established, and a correlation between lymph node sphericity and lymph node metastasis was revealed. By continuously fitting the size and characteristics of axillary lymph nodes on the 3D reconstruction system, formulas and models were established to determine the presence or absence of lymph node metastasis, and the 3D method had better sensitivity for axillary lymph node assessment than the 2D method, with a statistically significant difference in the correct classification rate. The combined diagnostic method was superior to a single diagnostic method, with a 92.3% correct classification rate for the 3D method combined with ultrasound. In addition, in patients who received neoadjuvant chemotherapy (NAC), the correct classification rate of the 3D method (72.7%) was significantly higher than that of ultrasound (45.5%) and CT (54.5%). By establishing an axillary lymph node atlas, the sphericity formula and model developed with the 3D reconstruction system achieve a high correct classification rate when combined with ultrasound or CT and can also be applied to patients receiving NAC."

基金机构：National Natural Science Foundation of China [82103678]; science and technology innovation Program of Hunan Province [2021SK2026]; Health and Family Planning Commission of Hunan Province [2022JJ70143]

基金资助正文：This study was funded by the National Natural Science Foundation of China (Grant No.: 82103678) and the science and technology innovation Program of Hunan Province (Grant No. 2021SK2026) and Health and Family Planning Commission of Hunan Province (Grant No. 2022JJ70143).