男性乳腺癌患者预后列线图的建立：一项监测、流行病学与最终结果数据库分析
Establishment of Prognostic Nomogram for Male Breast Cancer Patients: A Surveillance, Epidemiology and End Results Database Analysis.
作者信息
Ma Zhongjing, Xu Mengyao, Zhang Jingjiao, Li Jia, Fang Fengqi
机构信息
Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Gastroenterology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
出版信息
Cancer Control. 2024 Jan-Dec;31:10732748241270628. doi: 10.1177/10732748241270628.
BACKGROUND
Male breast cancer (MBC) represents a rare subtype of breast cancer, with limited prognostic factor studies available. The purpose of this research was to develop a unique nomogram for predicting MBC patient overall survival (OS) and breast cancer-specific survival (BCSS).
METHODS
From 2010 to 2020, clinical characteristics of male breast cancer patients were obtained from the Surveillance, Epidemiology and End Results (SEER) database. Following univariate and multivariate analyses, nomograms for OS and BCSS were created. Kaplan-Meier plots were further generated to illustrate the relationship between independent risk variables and survival. The nomogram's ability to discriminate was measured by employing the area under a time-dependent receiver operating characteristic curve (AUC) and calibration curves. Additionally, when the nomogram was used to direct clinical practice, we also used decision curve analysis (DCA) to evaluate the clinical usefulness and net clinical benefits.
RESULTS
A total of 2143 patients were included in this research. Univariate and multivariate analysis showed that age, grade, surgery, chemotherapy status, brain metastasis status, subtype, marital status, race, and AJCC-T, AJCC-N, and AJCC-M stages were significantly correlated with OS. Lung metastasis, age, marital status, grade, surgery, and AJCC-T, AJCC-N, and AJCC-M stages were significantly correlated with BCSS. By comprising these variables, a predictive nomogram was constructed in the SEER cohort. Then, it could be validated well in the validation cohort by receiver operating characteristics (ROCs) curve and calibration plot. Furthermore, the nomogram demonstrated better decision curve analysis (DCA) results, indicating the ability to forecast survival probability with greater accuracy.
CONCLUSION
We created and validated a unique nomogram that can assist clinicians in identifying MBC patients at high risk and forecasting their OS/BCSS.
背景
男性乳腺癌（MBC）是乳腺癌的一种罕见亚型，可用的预后因素研究有限。本研究的目的是开发一种独特的列线图，用于预测MBC患者的总生存期（OS）和乳腺癌特异性生存期（BCSS）。
方法
从2010年到2020年，男性乳腺癌患者的临床特征来自监测、流行病学和最终结果（SEER）数据库。经过单因素和多因素分析后，创建了OS和BCSS的列线图。进一步生成Kaplan-Meier曲线以说明独立风险变量与生存期之间的关系。通过使用时间依赖性受试者工作特征曲线（AUC）下面积和校准曲线来衡量列线图的辨别能力。此外，当使用列线图指导临床实践时，我们还使用决策曲线分析（DCA）来评估临床实用性和净临床效益。
结果
本研究共纳入2143例患者。单因素和多因素分析表明，年龄、分级、手术、化疗状态、脑转移状态、亚型、婚姻状况、种族以及AJCC-T、AJCC-N和AJCC-M分期与OS显著相关。肺转移、年龄、婚姻状况、分级、手术以及AJCC-T、AJCC-N和AJCC-M分期与BCSS显著相关。通过纳入这些变量，在SEER队列中构建了一个预测列线图。然后，通过受试者工作特征（ROC）曲线和校准图在验证队列中对其进行了良好的验证。此外，列线图显示出更好的决策曲线分析（DCA）结果，表明其能够更准确地预测生存概率。
结论
我们创建并验证了一种独特的列线图，可帮助临床医生识别高危MBC患者并预测其OS/BCSS。
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