摘要
目的:探讨非三阴乳腺癌预后不良风险预测模型的建立及临床价值。方法:选取198例非三阴性乳腺癌患者为研究对象,根据预后情况分为预后良好组(无病生存,n=146)及预后不良组(复发/转移/死亡,n=52)。比较两组患者的一般资料、实验室检查及病理样本结果;单因素和Logistic回归分析筛选危险因素;受试者工作特征(ROC)曲线建立预测模型,分析风险预测模型对非三阴性乳腺癌的诊断价值。结果:随访两年患者预后不良率为26.26%,其中原位复发12例,转移19例,死亡患者21例;术后两年总生存率为89.39%。年龄、BMI、NLR、经期状态、Ki-67、N分期是影响患者预后不良的独立危险因素(P<0.05),建立风险预测模型为h(t)=h_(0)(t)exp(0.136×年龄+0.274×BMI+0.626×NLR+1.173×经期状态+0.726×Ki-67+0.743×N分期)。ROC曲线分析显示,风险预测模型的曲线下面积(AUC)为0.857,敏感度为0.788,均高于年龄、BMI、NLR、经期状态、Ki-67、N分期(P<0.05);Hosmer-Lemeshow检验显示,该预测模型具有较好的拟合优度(χ^(2)=9.003,df=8,P>0.05)。结论:年龄、经期状态、BMI、NLR、Ki-67、N分期与非三阴性乳腺癌患者预后不良关系密切,据此建立的风险预估模型对患者预后具有较好的预测效能,有一定的临床推广价值。
Objective:To explore the establishment and clinical application of a risk prediction model for poor prognosis of non-triple-negative breast cancer.Methods:A total of 198 breast cancer patients were selected as the research objects,and they were divided into a good prognosis group(disease-free survival,n=146)and a poor prognosis group(recurrence,metastasis,death,n=52)according to their prognosis.The general information,laboratory examination and pathological sample results of the two groups of patients were compared.Univariate and Logistic regression analysis were used to screen risk factors.The receiver operating curve(ROC)was used to build the prediction model and analyze the diagnostic value of the risk prediction model for non-triple negative breast cancer.Results:The 2-years follow-up showed that the poor prognosis rate was 26.26%,including 12 patients with in-situ recurrence,19 patients with metastasis,and 21 patients with death.The overall survival rate was 89.39%after 2 years.Age,BMI,NLR,menstrual status,Ki-67 and N stage were independent risk factors for poor prognosis(P<0.05),the risk prediction model was established as h(t)=h_(0)(t)exp(0.136×age+0.274×BMI+0.626×NLR+1.173×menstrual status+0.726×Ki-67+0.743×N stage).The ROC curve showed that the area under the curve(AUC)of the prediction model was 0.857,and the sensitivity was 0.788,which were higher than those of age,BMI,NLR,menstrual status,Ki-67,and N stage(P<0.05).The Hosmer-Lemeshow test showed that the prediction model had good goodness of fit(χ^(2)=9.003,df=8,P>0.05).Conclusion:Age,menstrual status,BMI,NLR,Ki-67,and N stage are closely related to the poor prognosis of patients with non-triple-negative breast cancer.The risk prediction model established based on this has a good predictive effect on the prognosis of patients,and has certain clinical promotion value.
作者
蔡华霞
刘洋
闫宇
CAI Hua-xia;LIU Yang;YAN Yu(Department of Breast Surgery,the First Affiliated Hospital of Xi an Jiaotong University,Xi an 710000,Shaanxi,China)
出处
《川北医学院学报》
CAS
2022年第11期1396-1400,共5页
Journal of North Sichuan Medical College
基金
陕西省重点研发计划项目(2022SF-031)。
作者简介
蔡华霞(1985-),女,硕士,主治医师。E-mail:chx.306@163.com;通讯作者:闫宇,博士。E-mail:yanyu_xjtu@163.com。
