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:To establish and verify a risk prediction nomogram for ipsilateral axillary lymph node metastasis in breast cancer stage T1 （mass ≤ 2 cm）. :The clinicopathological data of 907 patients with T1 breast cancer who underwent surgical treatment from January 2010 to June 2015 were collected，including 573 cases from the Second Affiliated Hospital of Zhejiang University School of Medicine （modeling group） and 334 cases from Zhejiang University Lishui Hospital （verification group）. The risk factors of ipsilateral axillary lymph node metastasis were analyzed by univariate and multivariate logistic regression. The influencing factors were used to establish a nomogram for predicting ipsilateral axillary lymph nodes metastasis in T1 breast cancer. The model calibration，predictive ability and clinical benefit in the modeling group and the verification group were analyzed by C index，receiver operating characteristic curve，calibration curve and decision curve analysis （DCA） curve，respectively. :Univariate analysis showed that lymph node metastasis was related with primary tumor size，vascular tumor thrombus，Ki-67，histopathological grade，and molecular type （ vascular tumor thrombus，Ki-67 positive，estrogen receptor （ER） positive，and histopathological grade 2-3 were independent risk factors of axillary lymph node metastasis （<0.05 or <0.01）. Based on the independent risk factors，a nomogram prediction model was established. The C indexes of the model group and the validation group were 0.739 （95%:0.693-0.785） and 0.736 （95%:0.678-0.793），respectively. The calibration curve and DCA curve of the modeling group and the verification group indicated that the model was consistent and had good clinical benefit. :Primary tumor size，histopathological grade，vascular tumor thrombus，Ki-67，and ER status are predictors of ipsilateral axillary lymph node metastasis in T1 breast cancer. The established prediction nomogram can effectively predict the risk of ipsilateral axillary lymph node metastasis in T1 breast cancer，which can be used as a reference for individualized axillary management.
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Female , Humans , Axilla , Breast Neoplasms , Lymph Nodes , Lymphatic Metastasis , Nomograms , Retrospective StudiesABSTRACT
Objective: To evaluate the effect of postoperative chemotherapy on bone density change in the patients with breast cancer and the therapeutic effect of 99 TC-MDP.Methods: Totally 58 breast cancer patients with postoperative chemotherapy were se-lected, and the changes of bone density , blood calcium element (BGP), alkaline phosphatase (ALP) and 24 h urinary calcium levels were observed .After the chemotherapy , the osteoporosis patients were divided into the control group and the observation group , and the control group was given calcium carbonate D 3, while the observation group was given calcium carbonate D 3 combined with 99 TC-MDP. The bone density , BGP, ALP and 24 h urinary calcium levels were compared between the two groups .Results:After the chemothera-py, the bone mineral density of lumbar vertebra and thighbone was decreased significantly , BGP, ALP and 24 h urine Ca were in-creased significantly, and compared with those before the treatment , the differences were statistically significant (P<0.05).After the 3-course postoperative chemotherapy , the incidence of osteoporosis was 22.4%(13/58), and after the six-course chemotherapy, the incidence of osteoporosis was 39.7%(23/58).The bone mineral density of lumbar vertebra and thighbone in the observation group was increased significantly , BGP, ALP and 24 h urine Ca were decreased significantly , and compared with those in the control group , the differences were statistically significant (P<0.05).Conclusion: Postoperative chemotherapy for breast cancer can lead to reduced bone density , and 99 TC-MDP in the treatment of osteoporosis induced by breast cancer postoperative chemotherapy is safe and effective .
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0.05), Vmax, Vmean, and D 2 had statistical difference between different age groups(P
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Objective To establish a mathematic model of correlativity of human cytomegalovirus(HCMV) infection between mothers and their newborns.Method The plasma HCMV-IgM content,HCMV-DNA levels in plasm and peripheral blood mononuclear cells (PBMCs) were assayed with ELISA and PCR technique.Results There was a evident correlation between the two generation,and there was largest correlativity between HCMV-DNA level of mother's plasma and HCMV congenital infection rate,its spearman rank correlative coefficient was 0 7018(P