Cai Chang, Liu Tongshun, Zhao Jing, Zhang Kedong
Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou, China.
Research Institute of Advanced Manufacturing Technology, School of Mechanical and Electric Engineering, Soochow University, Suzhou, China.
Sci Rep. 2025 Apr 13;15(1):12703. doi: 10.1038/s41598-025-97681-1.
Primary breast signet ring cell carcinoma (BSRCC) is an extremely rare malignancy with poor prognosis. Few consensus exists regarding the prognostic factors and treatment modalities. This study aimed to develop a nomogram model to predict survival probability and guide clinical treatment for BSRCC patients. Clinicopathological data of BSRCC patients were retrieved from SEER database. Univariate and multivariate Cox regression analyses were performed to screen and identify prognostic factors. Kaplan-Meier method was used to describe the survival curve for each prognostic factor. Additionally, these factors were incorporated to construct nomograms for predicting overall survival (OS) and disease-specific survival (DSS) of BSRCC patients. The nomograms were internally validated using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA). A total of 362 eligible BSRCC patients were included in this study. Multivariate Cox analysis demonstrated that age at diagnosis, T stage, N stage, and surgery were identified as independent prognostic factors for OS, while grade, T stage, N stage, ER status, and surgery were independent DSS-related factors. Our study elucidated that surgery is the effective treatment for BSRCC, while postoperative radiotherapy does not confer additional benefit to patients. Nomograms were established to predict OS and DSS probability by incorporating independent prognostic factors among BSRCC patients. The nomograms were subsequently validated using ROC curves, calibration curves, and DCA to display the robust prognostic capability. Robust nomograms for OS and DSS of BSRCC patients were established, facilitating precise personalized risk assessment and appropriate treatment regimens in clinical practice.
原发性乳腺印戒细胞癌(BSRCC)是一种极其罕见的恶性肿瘤,预后较差。关于其预后因素和治疗方式,目前几乎没有共识。本研究旨在建立一种列线图模型,以预测BSRCC患者的生存概率并指导临床治疗。从监测、流行病学与最终结果(SEER)数据库中检索BSRCC患者的临床病理数据。进行单因素和多因素Cox回归分析,以筛选和确定预后因素。采用Kaplan-Meier法描述各预后因素的生存曲线。此外,将这些因素纳入构建列线图,以预测BSRCC患者的总生存(OS)和疾病特异性生存(DSS)。使用受试者工作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)对列线图进行内部验证。本研究共纳入362例符合条件的BSRCC患者。多因素Cox分析表明,诊断时年龄、T分期、N分期和手术被确定为OS的独立预后因素,而分级、T分期、N分期、雌激素受体(ER)状态和手术是与DSS相关的独立因素。我们的研究表明,手术是BSRCC的有效治疗方法,而术后放疗并未给患者带来额外益处。通过纳入BSRCC患者的独立预后因素,建立了预测OS和DSS概率的列线图。随后使用ROC曲线、校准曲线和DCA对列线图进行验证,以显示其强大的预后能力。建立了BSRCC患者OS和DSS的可靠列线图,有助于在临床实践中进行精确的个性化风险评估和制定合适的治疗方案。