Introduction
Materials and methods
Patients
Preoperative evaluation
Statistical analysis
Results
Clinicopathological profiles of the patients
Characteristics | Total (n = 705) | Training group (n = 509) | Validation group (n = 196) | P value |
---|---|---|---|---|
Age, years | ||||
Median (range) | 55 (26—90) | 54 (26—90) | 56 (27—90) |
0.033
|
Menopausal status | ||||
Premenopausal | 375 (53.2%) | 280 (55.0%) | 95 (48.5%) | 0.119 |
Postmenopausal | 330 (46.8%) | 229 (45.0%) | 101 (51.5%) | |
CEA (Ug/L) | ||||
Average | 2.773 ± 3.269 | 2.619 ± 2.444 | 3.171 ± 4.775 | 0.071 |
CA 125 (Ug/L) | ||||
Average | 15.012 ± 12.939 | 14.701 ± 14.021 | 15.818 ± 9.560 |
0.028
|
CA 153 (Ug/L) | ||||
Average | 11.415 ± 9.838 | 11.061 ± 8.538 | 12.335 ± 12.584 | 0.254 |
Tumor size | ||||
Average | 2.620 ± 1.476 | 2.636 ± 1.480 | 2.579 ± 1.469 | 0.478 |
T category | ||||
T1 | 330 (46.8%) | 228 (44.8%) | 102 (52.0%) | 0.22 |
T2 | 337 (47.8%) | 252 (49.5%) | 85 (43.4%) | |
T3 | 38 (5.4%) | 29 (5.7%) | 9 (4.6%) | |
Histology | ||||
Invasive ductal carcinoma | 601 (85.2%) | 434 (85.3%) | 167 (85.2%) | 0.177 |
Invasive lobular carcinoma | 26 (3.7%) | 18 (3.5%) | 8 (4.1%) | |
Mixed | 30 (4.3%) | 25 (4.9%) | 3 (2.6%) | |
Other | 48 (6.8%) | 32 (6.3%) | 16 (8.2%) | |
Biological subtype | ||||
Luminal A | 98 (13.9%) | 70 (13.8%) | 28 (14.3%) | 0.604 |
Luminal B | 449 (63.7%) | 325 (63.9%) | 124 (63.3%) | |
Her-2 amplified | 71 (10.1%) | 55 (10.8%) | 16 (8.2%) | |
TNBC | 87 (12.3%) | 59 (11.6%) | 28 (14.3%) | |
Tumor grade | ||||
Well differentiated, grade 1 | 78 (11.1%) | 51 (10.0%) | 27 (13.8%) | 0.341 |
Moderately differentiated, grade 2 | 297 (42.7%) | 215 (42.2%) | 82 (41.8%) | |
Poorly differentiated, grade 3 | 330 (46.8%) | 243 (47.7%) | 87 (44.4%) | |
Vascular invasion | ||||
No | 594 (84.3%) | 428 (84.1%) | 166 (84.7%) | 0.843 |
Yes | 111 (15.7%) | 81 (15.9%) | 30 (15.3%) | |
Calcification | ||||
No | 331 (47.0%) | 244 (47.9%) | 87 (44.4%) | 0.716 |
Yes | 374 (53.0%) | 265 (52.1%) | 109 (55.6%) | |
Lymph node metastasis | ||||
No | 437 (62.0%) | 322 (63.3%) | 115 (58.7%) | 0.261 |
Yes | 268 (38.0%) | 187 (36.7%) | 81 (41.3%) | |
Pathologic N category | ||||
N0 | 437 (62.0%) | 322 (63.3%) | 115 (58.7%) | 0.328 |
N1 | 159 (22.6%) | 113 (22.2%) | 46 (23.5%) | |
N2 | 65 (9.2%) | 41 (8.1%) | 24 (12.2%) | |
N3 | 44 (6.2%) | 33 (6.5%) | 11 (5.6%) | |
ER status | ||||
No | 160 (22.7%) | 116 (22.8%) | 44 (22.4%) | 0.923 |
Yes | 545 (77.3%) | 393 (77.2%) | 152 (77.6%) | |
PR status | ||||
No | 261(37.0%) | 192 (37.7%) | 69 (35.2%) | 0.535 |
Yes | 444(63.0%) | 317 (62.3%) | 127 (64.8%) | |
HER-2 status | ||||
Negative | 510 (72.3%) | 361 (70.9%) | 149 (76.0%) | 0.175 |
Overexpressed | 195 (27.7%) | 148 (29.1%) | 47 (24.0%) | |
Location | ||||
UOQ | 422 (59.9%) | 294(57.8%) | 128(65.3%) | 0.28 |
LOQ | 71 (10.1%) | 55(10.8%) | 16(8.2%) | |
LIQ | 76 (10.8%) | 60(11.8%) | 16(8.2%) | |
UIQ | 114 (16.2%) | 82(16.1%) | 32(16.3%) | |
Central | 22 (3.1%) | 18(3.5%) | 4(2.0%) |
Independent predictive factors for positive ALNs
Variable
|
Univariate analysis
|
Multi-variate analysis
| ||||
---|---|---|---|---|---|---|
Odds ratio | 95% CI | p-value | Odds ratio | 95% CI | P value | |
Age
| 0.852 | 0.733–0.999 | 0.036 | 0.993 | 0.975–1.011 | 0.435 |
CEA
| 1.282 | 1.188–1.384 | < 0.001 | 1.085 | 1.001–1.079 | 0.046 |
CA125
| 1.057 | 1.036–1.078 | < 0.001 | 1.052 | 1.027–1.077 | < 0.001 |
CA153
| 1.124 | 1.094–1.154 | < 0.001 | 1.073 | 1.042–1.105 | < 0.001 |
Tumor size
| 1.313 | 1.168–1.475 | < 0.001 | 1.145 | 1.009–1.299 | 0.036 |
Location
| ||||||
UOQ
| Reference | |||||
LOQ
| 0.605 | 0.327–1.118 | 0.109 | |||
LIQ
| 0.706 | 0.398–1.254 | 0.236 | |||
UIQ
| 0.659 | 0.395–1.099 | 0.110 | |||
Central
| 0.398 | 0.128–1.241 | 0.112 | |||
Vascular-invasion
| ||||||
No
| Reference | Reference | ||||
Yes
| 10.848 | 6.652–17.690 | < 0.001 | 7.736 | 3.903–15.332 | < 0.001 |
Calcification
| ||||||
No
| Reference | Reference | ||||
Yes
| 1.900 | 1.325–2.271 | < 0.001 | 1.650 | 1.082–2.514 | 0.02 |
Tumor grade
| ||||||
Well differentiated, grade 1
| Reference | |||||
Moderately differentiated, grade 2
| 4.362 | 1.775–10.718 | 0.001 | 5.338 | 1.514–18.840 | 0.009 |
Poorly differentiated, grade 3
| 5.657 | 2.318–13.804 | < 0.001 | 5.864 | 1.670–20.594 | 0.006 |
Histology subtype
| ||||||
Invasive ductal carcinoma
| Reference | |||||
Invasive lobular carcinoma
| 1.838 | 0.755–4.477 | 0.180 | |||
Mixed
| 2.056 | 0.964–4.379 | 0.062 | |||
Other
| 0.503 | 0.215–4.379 | 0.113 | |||
ER status
| ||||||
Negative
| 0.693 | 0.447–1.073 | 0.101 | |||
Positive
| Reference | |||||
PR status
| ||||||
Negative
| 0.680 | 0.469–0.986 | 0.045 | |||
Positive
| Reference | |||||
KI67
| 1.006 | 0.998–1.014 | 0.117 | |||
Her-2 status
| ||||||
Negative
| 0.920 | 0.626–1.352 | 0.673 | |||
Positive
| Reference | |||||
Biological subtype
| ||||||
Luminal A
| 1.147 | 0.532–2.474 | 0.726 | |||
Luminal B
| 1.932 | 1.046–3.567 | 0.035 | |||
Her-2 positive
| 1.554 | 0.706–3.421 | 0.273 | |||
TNBC
| Reference |