Department of Orthopedics, The Cancer Hospital of Shantou University Medical College, Shantou, China.
Department of Orthopedics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
Ann Med. 2023 Dec;55(1):2231342. doi: 10.1080/07853890.2023.2231342.
Due to the poor and unpredictable prognosis of breast cancer (BC) patients with bone metastasis, it is necessary to find convenient and available prognostic predictors. This study aimed to recognize the clinical and prognostic factors related to clinical laboratory examination and to construct a prognostic nomogram for BC bone metastasis.
We retrospectively analyzed 32 candidate indicators from clinical features and laboratory examination data of 276 BC patients with bone metastasis. Univariate and multivariate regression analyses were performed to identify significant prognostic factors related to BC with bone metastasis. Nomogram was constructed and estimated by receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis.
Patients were randomly grouped into training ( = 197) and validation cohorts ( = 79). In training cohort, the multivariate regression analysis revealed that age, other organ metastasis sites, serum level of lactate dehydrogenase, globulin, white blood cell count, mean corpuscular volume, mean corpuscular hemoglobin, and monocyte ratio were independent prognostic factors for BC with bone metastasis. The prognostic nomogram in training cohort exhibited areas under the ROC curve (AUCs) of 0.797, 0.782, and 0.794, respectively, for predicting 1-, 3-, and 5-year overall survival. In validation cohort, the nomogram still showed acceptable discrimination ability (AUCs: 0.723, 0.742, and 0.704) and calibration.
This study constructed a novel prognostic nomogram for BC patients with bone metastasis. It could serve as a potential tool of survival assessment to help individual treatment decision-making for clinicians.
由于乳腺癌(BC)伴骨转移患者的预后较差且不可预测,因此有必要寻找方便且可用的预后预测指标。本研究旨在识别与临床实验室检查相关的临床和预后因素,并构建用于预测 BC 骨转移的预后列线图。
我们回顾性分析了 276 例 BC 伴骨转移患者的临床特征和实验室检查数据中的 32 个候选指标。进行单变量和多变量回归分析,以确定与 BC 伴骨转移相关的显著预后因素。通过接收者操作特征(ROC)曲线、校准曲线和决策曲线分析构建和评估列线图。
患者被随机分为训练集(n=197)和验证集(n=79)。在训练集中,多变量回归分析显示,年龄、其他器官转移部位、血清乳酸脱氢酶、球蛋白、白细胞计数、平均红细胞体积、平均红细胞血红蛋白和单核细胞比例是 BC 伴骨转移的独立预后因素。训练集中的预后列线图在预测 1 年、3 年和 5 年总生存率方面的 ROC 曲线下面积(AUCs)分别为 0.797、0.782 和 0.794。在验证集中,该列线图仍显示出可接受的区分能力(AUCs:0.723、0.742 和 0.704)和校准。
本研究构建了一种用于 BC 伴骨转移患者的新型预后列线图。它可以作为一种潜在的生存评估工具,帮助临床医生为个体治疗决策。