乳腺叶状肿瘤术后复发的影响因素分析及风险模型构建  

Analysis of influencing factors of postoperative recurrence of phyllodes tumor of the breast and construction of risk model

作　　者：凌雪君 蒙剑飞 何中南 张燕侨 LING Xuejun;MENG Jianfei;HE Zhongnan;ZHANG Yanqiao(the People's Hospital of Hezhou,Hezhou 542899;Guangxi Institute of Cancer Prevention and Treatment,Nanning 531200,China)

机构地区：[1]贺州市人民医院,广西贺州542899 [2]广西壮族自治区肿瘤防治研究所,广西南宁531200

出　　处：《临床医学研究与实践》2025年第6期17-20,共4页Clinical Research and Practice

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(No.GXZYZ20210201);贺州市科学研究与技术开发计划项目(贺科技202249)。

摘　　要：目的 分析乳腺叶状肿瘤(PTB)术后复发的影响因素,并构建风险模型。方法 选取2010年1月至2020年12月于贺州市人民医院接受手术治疗的239例PTB患者为建模组,另选取2013年1月至2021年12月于贺州市人民医院接受手术治疗的80例PTB患者为外部验证组。采用多因素Cox回归模型筛选PTB患者术后复发的影响因素,并建立风险预测模型;采用受试者工作特征(ROC)曲线曲线下面积(AUC)、校准曲线及一致性指数(C-index)评估预测效能。结果 建模组复发35例,外部验证组复发9例。组织学类型、手术方式是PTB患者术后复发的影响因素(P<0.05)。建模组、外部验证组的C-index分别为0.825、0.948;术后5年复发率的AUC分别为0.872、0.874。校准曲线结果显示,列线图预测模型的结果与实际结果一致性良好。结论 组织学类型、手术方式是PTB患者术后复发的影响因素,基于上述因素建立的列线图预测模型显示出良好的预测能力,能够为PTB患者术后提供个性化的风险评估和预测。Objective To analyze the influencing factors of postoperative recurrence of phyllodes tumor of the breast(PTB),and to construct a risk model.Methods A total of 239 PTB patients who underwent surgical treatment in the People's Hospital of Hezhou from January 2010 to December 2020 were selected as modeling group,and 80 PTB patients who underwent surgical treatment in the People's Hospital of Hezhou from January 2013 to December 2021 were selected as external validation group.Multivariate Cox regression model was used to screen the influencing factors of postoperative recurrence in patients with PTB,and a risk prediction model was established;the area under curve(AUC)of the receiver operating characteristic(ROC),calibration curve and concordance index(C-index)were used to evaluate the predictive efficacy.Results There were 35 cases of recurrence in the modeling group and 9 cases in the external validation group.Histological type and surgical method were the influencing factors of postoperative recurrence in patients with PTB(P<0.05).The C-index of the modeling group and the external validation group were 0.825 and 0.948,respectively;the AUC of the 5-year recurrence rate after surgery was 0.872 and 0.874,respectively.The calibration curve results show that the results of the nomogram prediction model were in good agreement with the actual results.Conclusion Histological type and surgical method are the influencing factors of postoperative recurrence in PTB patients.The nomogram prediction model based on the above factors shows good predictive ability and can provide personalized risk assessment and prediction for PTB patients after surgery.

关 键 词：乳腺叶状肿瘤 术后复发 列线图 风险预测模型 

分 类 号：R737.9[医药卫生—肿瘤]