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三阴性乳腺癌伴远处转移的浸润性导管癌预后模型的建立:一项基于监测、流行病学和最终结果(SEER)数据库人群的研究

Establishment of prognostic model for invasive ductal carcinoma with distant metastasis within the triple-negative breast cancer: a SEER population-based study.

作者信息

Yang Minghao, Wang Chunxi, Ouyang Lu, Zhang Haowen, Lin Junlong

机构信息

General Surgery Department, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan.

General Surgery Department, Chinese PLA General Hospital, Beijing.

出版信息

Eur J Cancer Prev. 2025 Sep 1;34(5):392-404. doi: 10.1097/CEJ.0000000000000925. Epub 2025 Jul 30.

DOI:10.1097/CEJ.0000000000000925
PMID:39724567
Abstract

Triple-negative breast cancer (TNBC) is a complex and diverse group of malignancies. Invasive ductal carcinoma (IDC) is the predominant pathological subtype and is closely linked to the ominous potential for distant metastasis, a pivotal factor that significantly influences patient outcomes. In light of these considerations, the present study was conceived with the objective of developing a nomogram model. This model was designed to predict the prognosis observed in IDC with distant metastasis in TNBC. This was a retrospective study based on the SEER database. Data of 9739 IDC-TNBC patients diagnosed from 2010 to 2020 were included in our study. Independent risk factors were screened by univariate and multivariate Cox regression analyses successively, which were used to develop a nomogram model predicting for prognosis. Cox multivariable analysis showed statistical significance in bone metastasis, liver metastasis, surgery, and chemotherapy. Incorporating statistically significant variables, as well as clinically significant age, lung metastasis, and brain metastasis into the construction of the prediction model, the C-indexes of the training group and validation group were 0.702 (0.663-0.741) and 0.667 (0.600-0.734), respectively, while the calibration curves were all close to the eideal 45° reference line, and decision curve analysis curves show excellent net benefit in the predictive model. The prognostic prediction model developed in this study demonstrated enhanced predictive accuracy, enabling a more precise evaluation of mortality risks associated with IDC with distant metastasis in TNBC.

摘要

三阴性乳腺癌(TNBC)是一组复杂多样的恶性肿瘤。浸润性导管癌(IDC)是主要的病理亚型,与远处转移的不良可能性密切相关,这是一个显著影响患者预后的关键因素。鉴于这些考虑因素,本研究旨在开发一种列线图模型。该模型旨在预测TNBC中伴有远处转移的IDC患者的预后。这是一项基于监测、流行病学和最终结果(SEER)数据库的回顾性研究。我们的研究纳入了2010年至2020年诊断的9739例IDC-TNBC患者的数据。通过单因素和多因素Cox回归分析依次筛选独立危险因素,这些因素用于建立预测预后的列线图模型。Cox多变量分析显示骨转移、肝转移、手术和化疗具有统计学意义。将具有统计学意义的变量以及具有临床意义的年龄、肺转移和脑转移纳入预测模型的构建中,训练组和验证组的C指数分别为0.702(0.663-0.741)和0.667(0.600-0.734),而校准曲线均接近理想的45°参考线,决策曲线分析曲线在预测模型中显示出优异的净效益。本研究开发的预后预测模型显示出更高的预测准确性,能够更精确地评估TNBC中伴有远处转移的IDC患者的死亡风险。

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