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T3N0M0期乳腺癌的列线图构建与生存分析:一项基于监测、流行病学和最终结果(SEER)数据库人群的分析

Nomogram construction and survival analysis in T3N0M0 breast cancer: a SEER population-based analysis.

作者信息

Teng Lizhi, Zhang Zeyu, Du Juntong, Dong Yuhan, Tao Weiyang

机构信息

Department of Breast Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.

Key Laboratory of Acoustic, Optical and Electromagnetic Diagnosis and Treatment of Cardiovascular Diseases, Heilongjiang, China.

出版信息

Sci Rep. 2025 Jul 12;15(1):25194. doi: 10.1038/s41598-025-08518-w.

Abstract

Breast cancer, a heterogeneous disease, is notable for its high morbidity, recurrence, and mortality. T3N0M0 is controversial in terms of clinical prognosis and therapeutic decision-making. We collected baseline and treatment information on patients with T3N0M0 between 2010 and 2015 from the Surveillance, Epidemiology, and End Results programme (SEER) database. Univariate analyses of clinicopathological characteristics were performed using the log-rank test, while variables that were statistically significant (p < 0.05) were included in multivariate analyses to identify prognostic risk factors included in the construction of nomograms. Receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA) curves were applied to evaluate the nomogram. We obtained a total of 4,641 patient clinical characteristics from the SEER database. In T3N0M0 group, the overall survival (OS) for 3, 5 and 10 years was 87.1%, 79.5% and 71.6%, and breast cancer-specific survival (BCSS) was 92.0%, 88.1% and 85.3%, respectively. We ultimately identified eight variables (age, grade, surgery, radiation, chemotherapy, ER-status, PR-status, Her2-status) were associated with OS while seven variables (age, grade, surgery, radiation, chemotherapy, PR-status, Her2-status) were associated with BCSS. The nomogram was constructed based on independent prognostic risk factors, the area under the curve (AUC) values were well performed, the ROC curves, calibration curves and DCA curves all indicated that the nomogram had better clinical practicability. The current study provides a new clinical assessment tool for T3N0M0 breast cancer patients, as well as a reference for clinicians in selecting management decisions.

摘要

乳腺癌是一种异质性疾病,以其高发病率、复发率和死亡率而闻名。T3N0M0在临床预后和治疗决策方面存在争议。我们从监测、流行病学和最终结果计划(SEER)数据库中收集了2010年至2015年间T3N0M0患者的基线和治疗信息。使用对数秩检验对临床病理特征进行单因素分析,将具有统计学意义(p < 0.05)的变量纳入多因素分析,以确定构建列线图时包含的预后危险因素。应用受试者操作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)曲线来评估列线图。我们从SEER数据库中总共获得了4641例患者的临床特征。在T3N0M0组中,3年、5年和10年的总生存率(OS)分别为87.1%、79.5%和71.6%,乳腺癌特异性生存率(BCSS)分别为92.0%、88.1%和85.3%。我们最终确定了八个与OS相关的变量(年龄、分级、手术、放疗、化疗、雌激素受体状态、孕激素受体状态、人表皮生长因子受体2状态),而七个与BCSS相关的变量(年龄、分级、手术、放疗、化疗、孕激素受体状态、人表皮生长因子受体2状态)。基于独立的预后危险因素构建了列线图,曲线下面积(AUC)值表现良好,ROC曲线、校准曲线和DCA曲线均表明该列线图具有更好的临床实用性。本研究为T3N0M0乳腺癌患者提供了一种新的临床评估工具,也为临床医生选择治疗决策提供了参考。

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