Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.
The 2nd Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming, China.
Cancer Med. 2023 Mar;12(6):6499-6510. doi: 10.1002/cam4.5419. Epub 2022 Nov 6.
The function of stanniocalcin-1 (STC-1) in the oncogenesis and progression of tumors has been extensively studied. The purpose of this study was to investigate the relationship between secreted STC-1 and prognosis in patients with breast cancer (BC) and to determine whether STC-1 could be a key prognostic factor in BC.
The STC-1 level was measured by ELISA and clinical data from 1210 female patients with BC were used to develop and validate nomograms. We then verified the models through the plotting of ROC curves and calibration curves, calculating the C-index, and performing decision curve analyses (DCA).
The level of STC-1 in the peripheral plasma was significantly correlated with the T stage, N stage, clinical stage, grade, hormone receptors, HER-2 status, and tumor subtype. Cox regression analyses revealed that estrogen receptor(ER) status, N stage, and STC-1 level were risk factors for overall survival (OS), whereas T stage, N stage, and STC-1 level were independent prognostic factors for distant disease-free survival (DDFS) and disease-free survival (DFS). Both the ROC curve and the C-index confirmed the high resolution of these models, while the DCA identified the feasibility of their practical application. In addition, the calibration curves indicated good consistency between the predicted and actual survival rates.
Nomograms were created based on STC-1 levels for 3-, 5-, and 7-year OS, DDFS, and DFS of patients with BC respectively. As a key prognostic factor for BC, peripheral blood STC-1 level can be used clinically as a liquid biopsy indicator.
钙结合蛋白 STC-1 在肿瘤的发生和发展中的作用已经得到了广泛的研究。本研究旨在探讨分泌型 STC-1 与乳腺癌(BC)患者预后的关系,并确定 STC-1 是否可以成为 BC 的关键预后因素。
采用 ELISA 法检测 STC-1 水平,分析 1210 例女性 BC 患者的临床资料,建立并验证列线图。通过 ROC 曲线和校准曲线绘图、计算 C 指数和进行决策曲线分析(DCA)来验证模型。
外周血 STC-1 水平与 T 分期、N 分期、临床分期、分级、激素受体、HER-2 状态和肿瘤亚型显著相关。Cox 回归分析显示,雌激素受体(ER)状态、N 分期和 STC-1 水平是总生存期(OS)的危险因素,而 T 分期、N 分期和 STC-1 水平是无远处疾病复发生存期(DDFS)和无病生存期(DFS)的独立预后因素。ROC 曲线和 C 指数均证实了这些模型的高分辨率,而 DCA 则确定了其实际应用的可行性。此外,校准曲线表明预测生存率与实际生存率之间具有良好的一致性。
基于 STC-1 水平建立了用于预测 BC 患者 3、5、7 年 OS、DDFS 和 DFS 的列线图。作为 BC 的关键预后因素,外周血 STC-1 水平可作为一种液体活检指标用于临床。