Competing Risk Analyses of Medullary Carcinoma of Breast in Comparison to Infiltrating Ductal Carcinoma
Competing Risk Analyses of Medullary Carcinoma of Breast in Comparison to Infiltrating Ductal Carcinoma
复制标题
乳腺癌髓样癌与浸润性导管癌的竞争风险分析
DOI：
10.1038/s41598-019-57168-2
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发表时间：
2020-01-17
影响因子：
4.6
通讯作者：
Wang, Xian
中科院分区：
文献类型：
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作者：
Dai, Dongjun;Shi, Rongkai;Wang, Xian
本研究的目的是使用竞争风险模型来评估乳腺癌髓样癌(MCB)的预后是否好于乳腺浸润性导管癌(IDC)，并建立竞争风险图来预测MCB的死亡风险。我们从监测、流行病学和最终结果(SEER)数据库中纳入了3580名母婴传播疾病患者和319,566名IDC患者。IDC的BCS比MCB差(危险比(HR) >； 1，p <； 0.001)。疾病控制中心的5年累积死亡率(CID)高于母婴传播疾病(p <； 0.001)。肿瘤体积越大、阳性淋巴结数目越多、未婚状态越差(HR >； 1，p <； 0.001)。我们发现ER、PR、放疗或化疗与乳腺癌预后无关(p >； 0.05)。在惩罚变量选择过程之后，基于SH模型的诺模图通过对1,000个自举样本的内部判别和校准显示出中等的预测精度。综上所述，MCB患者的预后好于IDC患者。有趣的是，除了预期的危险因素，如更大的肿瘤大小和阳性淋巴结数的增加，未婚状态也被发现恶化了MCB的BCS。我们还建立了一个相互竞争的风险诺模图，作为一种简单易用的工具来评估MCB患者的预后。
The aim of current study was to use competing risk model to assess whether medullary carcinoma of the breast (MCB) has a better prognosis than invasive ductal carcinomas of breast cancer (IDC), and to build a competing risk nomogram for predicting the risk of death of MCB. We involved 3,580 MCB patients and 319,566 IDC patients from Surveillance, Epidemiology, and End Results (SEER) database. IDC was found to have a worse BCSS than MCB (Hazard ratio (HR) > 1, p < 0.001). The 5-year cumulative incidences of death (CID) was higher in IDC than MCB (p < 0.001). Larger tumor size, increasing number of positive lymph nodes and unmarried status were found to worsen the BCSS of MCB (HR > 1, p < 0.001). We found no association between ER, PR, radiotherapy or chemotherapy and MCB prognosis (p > 0.05). After a penalized variable selection process, the SH model-based nomogram showed moderate accuracy of prediction by internal validation of discrimination and calibration with 1,000 bootstraps. In summary, MCB patients had a better prognosis than IDC patients. Interestingly, unmarried status in addition to expected risk factors such as larger tumor size and increasing number of positive lymph nodes were found to worsen the BCSS of MCB. We also established a competing risk nomogram as an easy-to-use tool for prognostic estimation of MCB patients.