Departments of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
BMJ Open. 2023 Aug 7;13(8):e072632. doi: 10.1136/bmjopen-2023-072632.
The prognosis of invasive micropapillary carcinoma (IMPC) of the breast is determined by many clinicopathological factors. This study aims to identify prognostic factors and develop reliable nomogram to predict the overall survival (OS) in patients with IMPC.
Log-rank test and Cox proportional hazards analysis were used to identify variables and construct a nomogram based on the training cohort. C-index and calibration curves were performed to evaluate the performance of the model in the training cohort and validation cohorts.
We collected the patient data from the Surveillance, Epidemiology and End Results (SEER) database. This database holds data related to the cancer incidence from 18 population-based cancer registries in the USA.
The SEER database was used to screen 754 eligible patients as the study cohort. The whole cohort was randomly divided into a training cohort (n=377) and a validation cohort (n=377).
Age at diagnosis, hormone receptors, number of positive regional lymph nodes and clinical stage were independent prognostic factors for patients with IMPC. The calibration curves presented excellent consistency between the actual and nomogram-predict survival probabilities in the training and validation cohorts. The C-index values of the nomogram were 0.794 and 0.774 for OS in the training and validation cohorts, respectively.
The novel nomogram provides new insights of the risk of each prognostic factor and can assist doctors in predicting the 1-year, 3-year and 5-year OS in patients with IMPC.
浸润性微乳头状癌（IMPC）的预后由许多临床病理因素决定。本研究旨在确定预后因素，并建立可靠的列线图来预测 IMPC 患者的总生存率（OS）。
对数秩检验和 Cox 比例风险分析用于识别变量，并基于训练队列构建列线图。C 指数和校准曲线用于评估模型在训练队列和验证队列中的性能。
我们从监测、流行病学和最终结果（SEER）数据库中收集了患者数据。该数据库包含来自美国 18 个基于人群的癌症登记处的癌症发病率相关数据。
SEER 数据库用于筛选 754 名符合条件的患者作为研究队列。整个队列被随机分为训练队列（n=377）和验证队列（n=377）。
诊断时的年龄、激素受体、阳性区域淋巴结的数量和临床分期是 IMPC 患者的独立预后因素。在训练和验证队列中，校准曲线显示实际和列线图预测生存率之间具有极好的一致性。列线图的 C 指数值分别为 0.794 和 0.774，用于 OS 在训练和验证队列中的预测。
该新的列线图提供了每个预后因素风险的新见解，可以帮助医生预测 IMPC 患者的 1 年、3 年和 5 年 OS。
