School of Medicine, Sun Yat-sen University, Shenzhen, People's Republic of China.
Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China.
Clin Breast Cancer. 2024 Feb;24(2):e61-e70.e3. doi: 10.1016/j.clbc.2023.10.005. Epub 2023 Oct 22.
To develop a nomogram to predict the high-risk recurrence score (RS) and to customize the nomogram for different races in early-stage hormone receptor (HoR)-positive, human epidermal growth factor receptor-2 (HER2)-negative breast cancer.
Patients diagnosed between 2010 and 2015 were included from the surveillance, epidemiology, and end results oncotype DX database. The nomogram was assessed with a receiver operating characteristic curve to measure the area under the curve (AUC) with a 95% confidence interval (95% CI). The nomogram was developed and internally validated for discrimination and calibration, and then validated in different races.
A total of 48,464 patients were included and randomly assigned to the training cohort (n = 36370, 75.0%) and validation cohort (n = 12,094, 25.0%). Patients in the training cohort were identified to develop the nomogram, including 32,683 (89.9%) White women, 3135 (8.6%) Black women, and 552 (1.5%) Chinese women. Five independent predictive factors for high-risk RS were included to develop the nomogram, including tumor grade, progesterone receptor status, histological subtype, race, and tumor stage. The AUC was 0.696 (95% CI, 0.682-0.710) in the training cohort and 0.700 (95% CI, 0.676-0.724) in the validation cohort. There was no significant difference between the training cohort and the validation cohort. When validating the nomogram classified by race, the AUC was 0.694 (95% CI, 0.682-0.706) for the White cohort, 0.708 (95% CI, 0.673-0.743) for the Black cohort, and 0.653 (95% CI, 0.565-0.741) for the Chinese cohort.
The developed nomogram for predicting high-risk RS is available for different races in patients with HoR+/HER2- breast cancer, which could be used as qualified surrogates before ordering the 21-gene RS testing.
开发一种列线图来预测高风险复发评分（RS），并为早期激素受体（HoR）阳性、人表皮生长因子受体 2（HER2）阴性乳腺癌的不同种族定制列线图。
从监测、流行病学和最终结果肿瘤基因表达检测数据库中纳入 2010 年至 2015 年期间诊断的患者。使用接收者操作特征曲线评估列线图，以测量曲线下面积（AUC）和 95%置信区间（95%CI）。开发并内部验证了列线图的区分度和校准度，然后在不同种族中进行验证。
共纳入 48464 例患者，随机分配至训练队列（n=36370，75.0%）和验证队列（n=12094，25.0%）。在训练队列中识别出患者以开发列线图，其中包括 32683 例（89.9%）白人女性、3135 例（8.6%）黑人女性和 552 例（1.5%）中国女性。纳入 5 个独立的高风险 RS 预测因素来开发列线图，包括肿瘤分级、孕激素受体状态、组织学亚型、种族和肿瘤分期。在训练队列中，AUC 为 0.696（95%CI，0.682-0.710），在验证队列中为 0.700（95%CI，0.676-0.724）。训练队列和验证队列之间无显著差异。当按种族验证列线图分类时，白人队列的 AUC 为 0.694（95%CI，0.682-0.706），黑人队列为 0.708（95%CI，0.673-0.743），中国队列为 0.653（95%CI，0.565-0.741）。
为 HoR+/HER2-乳腺癌患者开发的预测高风险 RS 的列线图可用于不同种族，可作为订购 21 基因 RS 检测之前的合格替代指标。
