摘要目的 分析乳腺癌患者腋窝淋巴结转移与临床各因素之间的关系.并构建判断乳腺癌患者腋窝淋巴结转移的数学模型.方法 对423例女性乳腺癌患者,就年龄、肿瘤大小、激素受体、癌基因、是否绝经、生育及肿物位置及肿物多灶性等进行单因素分析,并通过Bayes判别构建乳腺癌腋窝淋巴结状态判断的数学诊断模型.结果 肿块大小与腋窝淋巴结转移的相关性显示原发肿瘤越大越易出现腋窝淋巴结转移;肿物位置亦与淋巴结转移密切相关,肿物呈多中心性者淋巴结转移率最高.而发病年龄、激素受体、癌基因表达及绝经、生育、肿物的多灶性均不能作为判断腋窝淋巴结转移的独立因素.Bayes判别构建的判断乳腺癌腋窝淋巴结状态的数学诊断模型,自我验证的准确率为89.4％,交互验证为74.7％.结论 肿物的位置、大小都是判断淋巴结转移的独立因素.建立数学函数对乳腺癌术前腋窝淋巴结转移状态的判断具有重要的临床意义.

abstractsObjective To analyze the relationship between axillary lymph node metastasis and clinical factors,and to construct a mathematical model of axillary lymph node metastasis in breast cancer patients.Methods Univariate analysis was performed on 423 female patients with breast cancer in terms of age,tumor size,hormone receptor,oncogene,menopause,fertility,tumor location and multifocal nature,and a mathematical diagnostic model for breast cancer axillary lymph node status was constructed by Bayes discrimination.Results The correlation between tumor size and axillary lymph node metastasis showed that the larger the primary tumor was,the more likely the axillary lymph node metastasis,the location of the tumor was also closely related to lymph node metastasis,and the lymph node metastasis rate was highest in patients with polycentric tumor.However,age of onset,hormone receptor,oncogene expression,menopause,fertility,and muhifocal tumor could not be independent factors in the determination of axillary lymph node metastasis.The accuracy of self-verification and cross-validation was 89.4％ and 74.7％ for the mathematical diagnostic model of axillary lymph node shape of breast cancer constructed by Bayes discrimination.Conclusion The location and size of the tumor were independent factors in the determination of lymph node metastasis.The establishment of mathematical function has important clinical significance for the preoperative diagnosis of axillary lymph node metastasis in breast cancer.