开发基于超声的提名图,用于预测三阴性乳腺癌结节阳性患者的病理完全反应和腋窝反应

IF 2.9 3区 医学 Q2 ONCOLOGY
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引用次数: 0

摘要

在新辅助化疗(NAC)前准确预测乳腺和腋窝淋巴结(ALN)的病理完全反应(pCR)对制定治疗策略至关重要。我们旨在根据超声(US)和临床病理学因素构建一个提名图,以预测结节阳性三阴性乳腺癌(TNBC)的乳腺和腋窝淋巴结 pCR。第一研究机构的328名TNBC患者为训练队列,第二研究机构的192名TNBC患者为验证队列。NAC前后均进行了US检查,并从病历中获得了患者的特征。通过单变量和多变量回归分析,确定了与训练队列中乳腺和 ALN pCR 相关的 US 和临床病理因素。使用接收操作特征曲线(ROC)、区分度和校准对预测性能进行了评估。总体而言,34.6% 的患者获得了乳腺癌 pCR,48.1% 的患者获得了 ALN pCR。用于预测乳腺 pCR 的提名图 1(AUC,0.84;95% CI:0.79,0.88)优于临床模型(AUC,0.73;95% CI:0.68,0.78)和美国模型(AUC,0.79;95% CI:0.74,0.83)。用于预测腋窝 pCR 的提名图 2(AUC:0.83;95% CI:0.78,0.87)也优于临床模型(AUC:0.64;95% CI:0.58,0.69)和 US 模型(AUC:0.80;95% CI:0.75,0.84)。校准曲线和判别曲线表明,提名图具有良好的校准性能和临床适用性。该提名图在预测 TNBC 患者的乳腺癌和 ALN pCR 方面显示出良好的预测性能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Development of an Ultrasound-based Nomogram for Predicting Pathologic Complete Response and Axillary Response in Node-Positive Patients with Triple- Negative Breast Cancer

Background

The accurate prediction of pathological complete response (pCR) in the breast and axillary lymph nodes (ALN) before neoadjuvant chemotherapy (NAC) is of utmost importance for the development of treatment strategies. We aim to construct a nomogram on ultrasound (US) and clinical-pathologic factors to predict breast and ALN pCR in node-positive triple-negative breast cancers (TNBCs).

Methods

Patients identified with TNBCs from institution 1 (n = 328) were used for training cohort and those from institution 2 (n = 192) were for validation cohort. US was conducted before and after NAC, and characteristics were obtained from medical records. Univariate and multivariate regression analysis were performed to identify US and clinical-pathologic factors associated with breast and ALN pCR in the training cohort. The assessment of predictive performance was conducted using the receiving operating characteristic curve (ROC), discrimination, and calibration.

Results

Overall, 34.6% of patients achieved breast pCR and 48.1% of patients achieved ALN pCR. The nomogram 1 used for predicting pCR in the breast (AUC, 0.84; 95% CI: 0.79, 0.88) outperformed the clinical (AUC, 0.73; 95% CI: 0.68, 0.78) and US models (AUC, 0.79; 95% CI: 0.74, 0.83). The nomogram 2 used for predicting pCR in the axllia (AUC, 0.83; 95% CI: 0.78, 0.87) also outperformed the clinical (AUC, 0.64; 95% CI: 0.58, 0.69) and US models (AUC, 0.80; 95% CI: 0.75, 0.84). The calibration curve and discrimination curve indicate that the nomogram has good calibration performance and clinical applicability.

Conclusion

The nomogram showed promising predictive performance for predicting breast and ALN pCR in patients with TNBCs.

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来源期刊
Clinical breast cancer
Clinical breast cancer 医学-肿瘤学
CiteScore
5.40
自引率
3.20%
发文量
174
审稿时长
48 days
期刊介绍: Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.
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