Predictive value of a multimodal ultrasound-based nomogram model for high Ki-67 expression in patients with breast invasive ductal carcinoma
YIN Weiwei
CHU Xiaoai
WANG Junli
QIN Xin
SHEN Chunyun
SUN Jing
XU Daojing
QIANG Banghong
XIE Yuxin
Abstract：Objective To explore the clinical reference value of a nomogram prediction model based on multimodal ultrasound features in predicting high Ki-67 expression in patients with invasive ductal carcinoma(IDC)of the breast.Methods Multimodal ultrasound imaging features and Ki-67 expression levels were collected from 180 patients with pathologically confirmed IDC who underwent surgery in our hospital from January 2020 to August 2024.Patients were divided into a high Ki-67 expression group(n=130)and a low Ki-67 expression group(n=50)based on a Ki-67 positivity rate of≥20%.Multimodal ultrasound parameters and clinical characteristics were compared between the two groups.Significant variables were screened through univariate analysis,and multivariate Logistic regression was further conducted to explore independent influencing factors.The final variables were selected through LASSO and stepwise regression methods,and a nomogram prediction model was constructed.Results The results of univariate and multivariate Logistic regression showed that the maximum diameter of the mass(OR=1.068,95%CI:1.022-1.115,P=0.003),microcalcification(OR=9.960,95%CI:4.183-23.715,P<0.001),virtual touch tissue imaging(VTI)(OR=7.937,95%CI:1.949-32.258,P=0.004),and the moth-eaten sign(OR=28.571,95%CI:4.808-166.667,P<0.001)were independent risk factors for high Ki-67 expression.A nomogram prediction model for high Ki-67 expression was established using variables such as the maximum diameter of the mass,microcalcification,VTI score≥4,and the moth-eaten sign.The results showed that the C-index of this model was 0.852.Internal validation through Bootstrap resampling suggested high consistency of the model,and clinical decision curve analysis indicated that the model had significant clinical net benefit.Conclusion Maximum tumor diameter,microcalcifications,VTI score≥4,and moth-eaten sign are independent factors influencing high Ki-67 expression in IDC patients.The nomogram prediction model for high Ki-67 expression,constructed based on these factors,demonstrates good predictive performance and provides a reference for clinical decision-making in IDC patients,potentially contributing to improved prognosis.
Keywords：invasive ductal carcinoma of the breastmultimodal ultrasoundKi-67nomogram
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 429-434 )