Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China.
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China.
BMC Cancer. 2021 Feb 16;21(1):168. doi: 10.1186/s12885-021-07895-5.
BACKGROUND: The prognositc factors in patient with invasive cribriform carcinoma (ICC) of breast is still remain controversal. The study aims to establish a nomogram to predict the survival outcomes in patients with ICC based on the Surveillance, Epidemiology and End Results (SEER) database. METHODS: We retrieved SEER database for clinical data about patients including ICC and infiltrating ductal carcinoma (IDC) from 2004 to 2015. Kaplan-Meier survival was used to compare the difference survival outcomes between ICC and IDC. ICC patients were randomly allocated to training cohort and validation cohort. A nomogram was built to predict individual patient's 3-year and 5-year survival status for ICC. The established TMN model and the newly established nomogram was further evaluated by the concordance index (C-index) and the decision curve analysis (DCA). RESULTS: Comparing the baseline clinical data between IDC and ICC, a significant of smaller tumor mass, less infiltrated lymph nodes, lower metastases rate, better tumor differentiation degree, higher proportion of estrogen receptor (ER) and progesterone receptor (PR) positive and lower rate of chemotherapy and radiotherapy was found in ICC. Age at diagnosis, marriage status, tumor location, T stage, M stage, ER status, surgery were independent significant prognostic factors for the overall survival (OS). A significantly higher C-index was found in nomogram compared with established TNM model in validation cohort. CONCLUSIONS: The prognosis of ICC patients is better than that of IDC patients. The nomogram is recommended for future patient with ICC to survival analysis.
背景:浸润性筛状癌(ICC)患者的预后因素仍存在争议。本研究旨在基于监测、流行病学和最终结果(SEER)数据库建立预测 ICC 患者生存结局的列线图。
方法:我们从 2004 年至 2015 年的 SEER 数据库中检索了 ICC 和浸润性导管癌(IDC)患者的临床数据。Kaplan-Meier 生存分析用于比较 ICC 和 IDC 之间生存结局的差异。ICC 患者被随机分配到训练队列和验证队列。建立列线图以预测 ICC 患者 3 年和 5 年的生存状况。进一步通过一致性指数(C 指数)和决策曲线分析(DCA)评估新建立的 TMN 模型和列线图。
结果:比较 IDC 和 ICC 的基线临床数据,ICC 中肿瘤体积较小、浸润淋巴结较少、转移率较低、肿瘤分化程度较好、雌激素受体(ER)和孕激素受体(PR)阳性比例较高、化疗和放疗比例较低。诊断时年龄、婚姻状况、肿瘤位置、T 分期、M 分期、ER 状态、手术是总生存期(OS)的独立预后因素。验证队列中,列线图的 C 指数明显高于已建立的 TNM 模型。
结论:ICC 患者的预后优于 IDC 患者。建议未来的 ICC 患者使用列线图进行生存分析。
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