Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000, China.
Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000, China; Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 210000, China.
Breast. 2022 Dec;66:8-14. doi: 10.1016/j.breast.2022.08.011. Epub 2022 Sep 2.
Triple-negative apocrine carcinoma (TNAC) is a sort of triple-negative breast cancer (TNBC) that is rare and prognosis of these patients is unclear. The present study constructed an effective nomogram to assist in predicting TNAC patients overall survival (OS).
A total of 373 TNAC patients from the surveillance, epidemiology, and end results (SEER) got extracted from 2010 to 2016 and were divided into training (n = 261) and external validation (n = 112) groups (split ratio, 7:3) randomly. A Cox regression model was utilized to creating a nomogram according to the risk factors affecting prognosis. The predictive capability of the nomogram was estimated with receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).
Multivariate Cox regression analysis revealed age, surgery, chemotherapy, stage, and first malignant primary as independent predictors of OS. A prediction model was constructed and virtualized using the nomogram. The time-dependent area under the curve (AUC) showed satisfactory discrimination of the nomogram. Good consistency was shown on the calibration curves in OS between actual observations and the nomogram prediction. What's more, DCA showed that the nomogram had incredible clinical utility. Through separating the patients into groups of low and high risk group that connects with the risk system that shows a huge difference between the low-risk and high risk OS (P < 0.001).
To predict the OS in TNAC patients, the nomogram utilizing the risk stratification system that is corresponding. These tools may help to evaluate patient prognosis and guide treatment decisions.
三阴性大汗腺癌(TNAC)是一种罕见的三阴性乳腺癌(TNBC),其患者的预后尚不清楚。本研究构建了一种有效的列线图来辅助预测 TNAC 患者的总生存(OS)。
从 2010 年至 2016 年,从监测、流行病学和最终结果(SEER)中提取了 373 名 TNAC 患者,并随机分为训练(n=261)和外部验证(n=112)组(分割比例为 7:3)。利用 Cox 回归模型根据影响预后的风险因素构建列线图。通过接受者操作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)评估列线图的预测能力。
多变量 Cox 回归分析显示年龄、手术、化疗、分期和首次恶性原发灶是 OS 的独立预测因素。构建并通过列线图可视化了预测模型。时间依赖性曲线下面积(AUC)显示列线图具有良好的区分度。OS 实际观察值与列线图预测值之间的校准曲线显示出良好的一致性。此外,DCA 表明列线图具有极好的临床实用性。通过将患者分为低危和高危组,可以与风险系统相连接,两组间 OS 存在显著差异(P<0.001)。
通过使用风险分层系统构建列线图来预测 TNAC 患者的 OS。这些工具可以帮助评估患者的预后并指导治疗决策。