基于SEER数据库的炎性乳腺癌生存预测风险模型的建立与验证  

Establishment and validation of a nomogram to predict cancer-specific survival for patients with inflammatory breast cancer based on SEER database

作　　者：黄雅静 吴昊 陈彦[1] 李兴睿[1] HUANG Yajing;WU Hao;CHEN Yan;LI Xingrui(Department of Thyroid and Breast Surgery,Huazhong University of Science and Technology,Hubei Wuhan 430030,China;Department of General Surgery,Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院甲状腺乳腺外科,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院普通外科,湖北武汉430030

出　　处：《现代肿瘤医学》2022年第6期1023-1027,共5页Journal of Modern Oncology

基　　金：湖北省科技计划项目(编号:2019CFB662)。

摘　　要：目的:建立可预测炎性乳腺癌(inflammatory breast cancer,IBC)生存情况的风险模型。方法:利用监测、流行病学和结果(Surveillance,Epidemiology and End Results,SEER)数据库,筛选2010年至2015年诊断为IBC的病例,通过单因素和Logistic多因素回归分析,明确与生存相关的独立危险因素,构建预测IBC患者1年、3年和5年肿瘤特异性生存(cancer-specific survival,CSS)率的列线图,并用Harrell's一致性指数(C-index)和预测模型校准曲线对该模型进行验证,评估预测效能。结果:共筛选出2754例符合纳入标准的IBC病例,随机分出1933例作为训练组,821例作为验证组。通过单因素和多因素分析显示年龄、种族、肿瘤组织学分级、N分期、M分期、分子分型、手术、放疗和化疗是与病人CSS显著相关的独立危险因素。利用上述预后相关因素建立列线图模型,内部验证C-index是0.731(95%CI:0.714~0.749),外部验证是0.752(95%CI:0.777~0.727),校准曲线显示预测情况与实际观察情况拟合良好。结论:年龄、种族、肿瘤组织学分级、N分期、M分期、分子分型、手术、放疗和化疗是影响IBC病人生存的独立危险因素,以此建立的列线图预测模型能较好地评估病人生存情况。Objective:To establish a risk model to predict inflammatory breast cancer(IBC)survival.Methods:The cases diagnosed as IBC from 2010 to 2015 were screened using Surveillance,Epidemiology and End Results(SEER)database.Univariate and Logistic multivariate regression analysis were performed to identify the independent risk factors related to IBC survival and further establish a nomogram to predict 1-,3-,and 5-year cancer-specific survival(CSS)of IBC patients.Harrell's C-index and calibration curve were used to validate the nomogram.Results:A total of 2754 IBC cases that met the inclusion criteria were screened out,and 1933 cases were randomly selected as the training set and 821 cases were selected as validation set.Univariate and multivariate analyses showed that age,race,histological grade,N stage,M stage,breast subtype,surgery,radiotherapy and chemotherapy were independent risk factors significantly associated CSS.The internally and externally validated Harrell's C-indexes were 0.731(95%CI:0.714~0.749)and 0.752(95%CI:0.777~0.727).The calibration curve showed that the prediction fits well for the 1-,3-,and 5-year CSS.Conclusion:Age,race,histological grade,N stage,M stage,breast subtype,surgery,radiotherapy and chemotherapy are independent risk factors affecting the survival of IBC patients.The nomogram constructed based on the risk factors can better evaluate the survival of IBC patients individually.

关 键 词：炎性乳腺癌 预后 SEER 列线图 

分 类 号：R737.9[医药卫生—肿瘤]