基于监测、流行病学和最终结果(SEER)数据库的未经治疗的三阴性乳腺癌的自然病史和预后列线图

Natural history and prognostic nomogram of untreated triple negative breast cancer based on SEER database.

作者信息

Wang Dasong, Yang Yan, Rong Wei, Fan Li, Yang Lei, Chen Maoshan, Yang Hongwei, He Yu

机构信息

Department of Breast and Thyroid Surgery, Suining Central Hospital, No. 127 Desheng West Road, Chuanshan District, Suining City, Sichuan Province, China.

出版信息

Sci Rep. 2025 Jul 2;15(1):23347. doi: 10.1038/s41598-025-07114-2.

Abstract

Triple-negative breast cancer (TNBC) is an aggressive subtype with a relatively poor prognosis, and its natural history without therapeutic intervention remains understudied. The purpose of this study was to investigate the natural history of untreated TNBC and construct a prognostic model utilizing data from the SEER database. Data from patients diagnosed with TNBC between 2010 and 2021 were analyzed. Median survival times for each tumor stage were calculated to estimate disease progression time (defined as the difference in median survival between consecutive stages). Cox regression was employed to identify independent prognostic factors in a training set, and a prognostic nomogram was developed based on these factors. Results showed that median survival times for untreated TNBC were 65 months (stage I), 28 months (stage II), 11 months (stage III), and 3 months (stage IV), with estimated progression times from stage I to II, II to III, and III to IV being 37 months, 17 months, and 8 months, respectively. Age, multifocal breast cancer, T stage, M stage, liver metastasis, and brain metastasis were identified as independent risk factors. The nomogram demonstrated excellent predictive performance, with a C-index of 0.795 in the training set and 0.759 in the validation set, supported by favorable calibration plots and decision curve analysis (DCA). In conclusion, untreated TNBC exhibited accelerated progression and deteriorating prognosis with increasing tumor stage, with age and tumor burden serving as key prognostic indicators, and the constructed nomogram provided a reliable tool for predicting survival in untreated TNBC patients.

摘要

三阴性乳腺癌(TNBC)是一种侵袭性亚型,预后相对较差,其未经治疗干预的自然病程仍未得到充分研究。本研究的目的是调查未经治疗的TNBC的自然病程,并利用监测、流行病学和最终结果(SEER)数据库的数据构建一个预后模型。分析了2010年至2021年期间诊断为TNBC的患者的数据。计算每个肿瘤分期的中位生存时间,以估计疾病进展时间(定义为连续分期之间中位生存时间的差异)。采用Cox回归在训练集中识别独立的预后因素,并基于这些因素开发了一个预后列线图。结果显示,未经治疗的TNBC的中位生存时间分别为65个月(I期)、28个月(II期)、11个月(III期)和3个月(IV期),从I期到II期、II期到III期和III期到IV期的估计进展时间分别为37个月、17个月和8个月。年龄、多灶性乳腺癌、T分期、M分期、肝转移和脑转移被确定为独立的危险因素。该列线图显示出优异的预测性能,训练集中的C指数为0.795,验证集中的C指数为0.759,校准图和决策曲线分析(DCA)结果良好。总之,未经治疗的TNBC随着肿瘤分期增加呈现出进展加速和预后恶化的情况,年龄和肿瘤负荷是关键的预后指标,构建的列线图为预测未经治疗的TNBC患者的生存提供了可靠工具。

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