Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer
Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer
复制标题
预测中国三阴性乳腺癌患者生存期的列线图的开发和验证
DOI：
10.1186/s12885-019-5703-4
复制
发表时间：
2019-06-06
期刊：
影响因子：
3.8
通讯作者：
Liu, Jieqiong
中科院分区：
文献类型：
--
作者：
Yang, Yaping;Wang, Ying;Liu, Jieqiong
背景三阴性乳腺癌（TNBC）是一种侵袭性和异质性疾病。预测TNBC预后的nomogram是风险管理所必需的。方法对2002 - 2014年中山纪念医院收治的296例非转移性TNBC患者进行x线图分析。终点为无病生存期（DFS）和总生存期（OS）。采用一致性指数（C-index）、曲线下面积（AUC）和校准曲线评价预测准确性和判别能力，并与美国癌症联合委员会（AJCC）分期系统、PREDICT和CancerMath进行比较。采用2007年至2012年湘雅第二医院和北京大学深圳医院191例患者的独立队列对模型进行了内部验证和外部验证。结果在训练队列的多变量分析中，独立预后因素为基质肿瘤浸润淋巴细胞（til）、肿瘤大小、淋巴结状态和Ki67指数，并将其纳入nomogram。对DFS和OS概率的标定曲线显示nomogram预测值与实际观测值的一致性较好。预测DFS的nomogram C-index（训练值）分别为0.743 vs 0.666 （P=0.003）和0.664 (P=0.024)；验证：0.784 vs 0.632 （P=0.02）和0.607 (P=0.002))，操作系统(训练：0.791 vs 0.683 （P=0.004）和0.677 （P=0.002）
BackgroundTriple negative breast cancer (TNBC) is an aggressive and heterogeneous disease. Nomograms predicting outcomes of TNBC are needed for risk management.MethodsNomograms were based on an analysis of 296 non-metastatic TNBC patients treated at Sun Yat-sen Memorial Hospital from 2002 to 2014. The end points were disease-free survival (DFS) and overall survival (OS). Predictive accuracy and discriminative ability were evaluated by concordance index (C-index), area under the curve (AUC) and calibration curve, and compared with the American Joint Committee on Cancer (AJCC) staging system, PREDICT and CancerMath. Models were subjected to bootstrap internal validation and external validation using independent cohorts of 191 patients from the second Xiangya Hospital and Peking University Shenzhen Hospital between 2007 and 2012.ResultsOn multivariable analysis of training cohort, independent prognostic factors were stromal tumor-infiltrating lymphocytes (TILs), tumor size, node status, and Ki67 index, which were then selected into the nomograms. The calibration curves for probability of DFS and OS showed optimal agreement between nomogram prediction and actual observation. The C-index of nomograms was significantly higher than that of the seventh and eighth AJCC staging system for predicting DFS (training: 0.743 vs 0.666 (P=0.003) and 0.664 (P=0.024); validation: 0.784 vs 0.632 (P=0.02) and 0.607 (P=0.002)) and OS (training: 0.791 vs 0.683 (P=0.004) and 0.677 (P