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通过联合列线图方法提高侵袭性三阴性乳腺癌的预后价值

英文原题:Improving Prognostic Value in Invasive Triple Negative Breast Cancer Through a Combined Nomogram Approach.

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Improving Prognostic Value in Invasive Triple Negative Breast Cancer Through a Combined Nomogram Approach.

PubMed 2024/11/22(内容时间) Clin Breast Cancer Q3 · IF 2.7(JCR 2025)

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研究概要

将 AJCC 分期与 US 评分、间质 TILs 和 LVI 结合,相比单独常规 AJCC 分期,提高了预测侵袭性 TNBC 患者不良结局的模型性能。

研究思路结论见上方概要

探讨超声(US)特征联合病理标志物的潜在预后价值,并初步建立预测侵袭性三阴性乳腺癌(TNBC)患者不良结局的工作模型。

自2012年1月至2018年12月,我们纳入了209例接受标准治疗的TNBC患者,系统收集了US参数、间质TIL(肿瘤浸润淋巴细胞)(TILs)、淋巴血管侵犯(LVI)状态及其他相关信息,并记录了随访数据。构建并验证了结合AJCC分期与US评分、间质TILs和LVI的列线图,用于预测侵袭性TNBC患者的不良结局,即复发或死亡。

US评分4分与TNBC患者不良结局关系最密切(HR 3.87,P = .015)。在训练集中,列线图的预后价值显著高于单独使用AJCC分期[曲线下面积(AUC),0.74 vs. 0.64,P = .045],且与验证集相当(AUC,0.71 vs. 0.63,P = .804)。在训练集和验证集中,列线图预测的生存概率与实际生存概率之间均具有可接受的一致性,Brier评分分别为0.15和0.13。

展开英文摘要原文

To investigate the potential prognostic value of ultrasound (US) features in conjunction with pathological markers and to develop a preliminary working model for predicting poor outcomes in patients with invasive triple-negative breast cancer (TNBC).

From January 2012 to December 2018, we enrolled 209 TNBC patients treated with standard therapy, systematically gathered data on US parameters, stromal tumor-infiltrating lymphocytes (TILs), lymphovascular invasion (LVI) status, and other relevant information, and recorded follow-up data. A nomogram combining AJCC staging with US score, stromal TILs, and LVI was constructed and validated to predict poor outcomes, defined as recurrence or death, in patients with invasive TNBC.

The US score of 4 was best related to poor outcomes in patients with TNBC (HR 3.87, P = .015). In the training set, the nomogram had a considerably greater prognostic value [area under the curve (AUC), 0.74 vs. 0.64, P = .045] than AJCC staging alone, and it was comparable to that of the validation set (AUC, 0.71 vs. 0.63, P = .804). An acceptable consistency between the nomogram-predicted and actual survival probabilities was found both in the training and validation sets, with Brier scores of 0.15 and 0.13, respectively.

The incorporation of AJCC stage with US score, stromal TILs, and LVI improved the model performance for predicting poor outcomes in patients with invasive TNBC compared to routine AJCC staging alone.

论文信息

作者
Li L、Liu Z、Chen K、Li Y
第一作者单位
Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China.China
通讯作者单位
Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address: lyjia@smu.edu.cn.China
期刊
Clinical breast cancer2025 Apr
原文标识
PubMed 39674765 · DOI 10.1016/j.clbc.2024.11.013