摘要
目的探讨影响亚裔人群T_(1c)期乳腺癌患者生存的预后因素,并构建列线图预测模型。方法收集监测、流行病学和最终结果(SEER)数据库2010年至2015年T_(1c)期亚裔乳腺癌患者的临床数据作为建模组。对建模组进行Cox单因素和多因素分析,使用R软件构建列线图。采用一致性指数及受试者工作特征(ROC)曲线评估模型的可信度。收集山西医科大学第二医院2015年1月至2020年12月诊断为T_(1c)期的乳腺癌患者作为验证组,对模型进行验证。绘制生存校正曲线,检测两组的一致性。结果共纳入T_(1c)期乳腺癌患者5328例,其中建模组4968例,验证组360例。中位随访时间分别为53个月和43个月,建模组死亡170例,验证组死亡13例。Cox多因素分析显示,年龄、组织学分级、ER和PR表达、HER-2状态、分子分型、N分期、M分期、手术和放化疗均为影响T_(1c)期乳腺癌患者总生存时间的独立因素(P<0.01)。构建列线图预测模型。建模组C指数为0.701(95%CI:0.693~0.709),验证组C指数为0.686(95%CI:0.657~0.715)。3、5年生存率ROC曲线显示,曲线下面积(AUC)分别为0.769、0.694。3年生存率校正曲线显示,验证组校正曲线与建模组结果高度拟合。结论成功构建了预后预测模型,对亚裔T_(1c)期乳腺癌患者的3年生存率作出预测,可为临床医师做治疗决策时提供参考。
Objective To study the prognostic factors that affect the survival of stage T_(1c) breast cancer patients in Asian population,and construct nomogram for prognostic prediction.Methods The clinical data of stage T_(1c) Asian breast cancer patients in Surveillance Epidemiology and End Results(SEER)database from 2010 to 2015 were collected as the modeling group.Cox single factor and multi factor analysis were performed on the modeling group,and the nomogram was constructed using R software.The consistency index and receiver operating curve(ROC)were used to evaluate the reliability of the model.Patients with stage T_(1c) breast cancer diagnosed in the Second Hospital of Shanxi Medical University from Jan 2015 to Dec 2020 were collected as the validation group to validate the model.The survival correction curve was drawn and the consistency of the two groups was further detected.Results A total of 5328 patients with stage T_(1c) breast cancer were enrolled,including 4968 cases in the modeling group and 360 cases in the validation group.The median follow-up time was 53 months and 43 months for the modeling group and the validation group,respectively,and 170 cases died in the modeling group and 13 cases died in the validation group.Cox multivariate analysis showed that age,histological grade,ER and PR expression,HER-2 status,molecular typing,N stage,M stage,surgery,radiotherapy and chemotherapy were all independent factors affecting overall survival in patients with stage T_(1c) breast cancer(P<0.01).Nomogram prediction model was further constructed.The C index of the modeling group was 0.701(95%CI:0.693-0.709),and that of the validation group was 0.686(95%CI:0.657-0.715).ROC curve of the 3-and 5-year survival rate showed that the area under the curve(AUC)was 0.769 and 0.694 respectively.The 3-year survival correction curve showed that the correction curve of the validation group was highly matched with the results of the modeling group.Conclusion A prognosis prediction model is successfully constructed to predict the 3-
作者
喻小力
曲南坤
梁爽
姜鸿南
胡耀峰
任栋梁
朱思渊
王伏生
YU Xiaoli;QU Nankun;LIANG Shuang;JIANG Hongnan;HU Yaofeng;REN Dongliang;ZHU Siyuan;WANG Fusheng(Second Clinical Medical College,Shanxi Medical University,Taiyuan 030001,China)
出处
《临床肿瘤学杂志》
CAS
2022年第7期608-615,共8页
Chinese Clinical Oncology
基金
山西省基础研究计划资助项目(20210302123441)。
