Preoperative Breast Immune Prognostic Index as Prognostic Factor Predicts the Clinical Outcomes of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy.
Preoperative Breast Immune Prognostic Index as Prognostic Factor Predicts the Clinical Outcomes of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy.
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术前乳腺免疫预后指数作为预后因素预测接受新辅助化疗的乳腺癌患者的临床结果
DOI：
10.3389/fimmu.2022.831848
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发表时间：
2022
影响因子：
7.3
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Chen L;Kong X;Huang S;Su Z;Zhu M;Fang Y;Zhang L;Li X;Wang J
本研究旨在探讨乳房免疫预后指数(BIPI)对接受新辅助化疗(NACT)的乳腺癌患者的潜在预后意义。通过受试者工作特性曲线(ROC)计算最佳截止值。用卡方检验或Fisher‘s精确检验确定BIPI与临床病理特征的相关性。生存概率的估计采用Kaplan-Meier法，生存概率的差异分析采用对数秩检验法。采用单因素和多因素Cox比例风险回归模型筛选独立的预后因素。在多因素分析的基础上，建立无病生存期(DFS)和总生存期(OS)的预后诺模图。此外，使用校准曲线和决策曲线分析(DCA)来评估诺模图的预测性能。根据BIPI评分，所有入选患者被分为三个亚组。BIPI评分0分组和BIPI评分1分组的平均DFS和OS明显长于BIPI评分2组(42.02比38.61比26.01个月，77.61比71.83比53.15个月；p<；0.05)。单因素和多因素分析显示，BIPI是影响DFS和OS的独立预后因素(DFS，危险比(HR)：6.720，95%可信区间(CI)：1.629~27.717；OS，HR：8.006，95%CI：1.638~39.119)。C指数为0.873(95%CI：0.779-0.966)和0.801(95%CI：0.702-0.901)的诺模图结合其他临床特征预测DFS和OS生存率具有良好的效果。1、3和5年生存的校准曲线表明，预测的DFS和OS概率与实际的DFS和OS概率有很好的一致性。DCA显示，在预测5年DFS和OS预后评估的临床应用中，所构建的诺模图比仅有BIPI具有更好的临床预测性。BIPI评分低的患者预后较好，DFS和OS较长。此外，基于BIPI的诺模图可以作为乳腺癌的一种方便的预后工具，并有助于临床决策。
This study aims at investigating the potential prognostic significance of the breast immune prognostic index (BIPI) in breast cancer patients who received neoadjuvant chemotherapy (NACT). The optimal cutoff value was calculated through the receiver operating characteristic curve (ROC). The correlations between BIPI and clinicopathologic characteristics were determined by the chi-square test or Fisher’s exact test. The Kaplan–Meier method was used to estimate the survival probability, and the log-rank test was used to analyze the differences in the survival probability among patients. The univariate and multivariate Cox proportional hazard regression model was used to screen the independent prognostic factors. A prognostic nomogram for disease-free survival (DFS) and overall survival (OS) was built on the basis of the multivariate analyses. Furthermore, the calibration curve and decision curve analysis (DCA) were used to assess the predictive performance of the nomogram. All enrolled patients were split into three subgroups based on the BIPI score. The mean DFS and OS of the BIPI score 0 group and BIPI score 1 group were significantly longer than those of the BIPI score 2 group (42.02 vs. 38.61 vs. 26.01 months, 77.61 vs. 71.83 vs. 53.15 months; p < 0.05). Univariate and multivariate analyses indicated that BIPI was an independent prognostic factor for patients’ DFS and OS (DFS, hazard ratio (HR): 6.720, 95% confidence interval (CI): 1.629–27.717; OS, HR: 8.006, 95% CI: 1.638–39.119). A nomogram with a C-index of 0.873 (95% CI: 0.779–0.966) and 0.801 (95% CI: 0.702–0.901) had a favorable performance for predicting DFS and OS survival rates for clinical use by combining immune scores with other clinical features. The calibration curves at 1-, 3-, and 5-year survival suggested a good consistency between the predicted and actual DFS and OS probability. The DCA demonstrated that the constructed nomogram had better clinical predictive usefulness than only BIPI in predictive clinical applications of 5-year DFS and OS prognostic assessments. The patients with low BIPI score have better prognoses and longer DFS and OS. Furthermore, the BIPI-based nomogram may serve as a convenient prognostic tool for breast cancer and help in clinical decision-making.
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影响因子：
10.9
作者：
Capone M;Giannarelli D;Mallardo D;Madonna G;Festino L;Grimaldi AM;Vanella V;Simeone E;Paone M;Palmieri G;Cavalcanti E;Caracò C;Ascierto PA
通讯作者：
Ascierto PA
影响因子：
5.5
作者：
Chen L;Bai P;Kong X;Huang S;Wang Z;Wang X;Fang Y;Wang J
通讯作者：
Wang J
影响因子：
6
作者：
Grassadonia A;Graziano V;Iezzi L;Vici P;Barba M;Pizzuti L;Cicero G;Krasniqi E;Mazzotta M;Marinelli D;Amodio A;Natoli C;Tinari N
通讯作者：
Tinari N
影响因子：
45.3
作者：
Armstrong, Andrew J.;George, Daniel J.;Halabi, Susan
通讯作者：
Halabi, Susan
影响因子：
--
作者：
Fisusi, Funmilola A.;Akala, Emmanuel O.
通讯作者：
Akala, Emmanuel O.