第二种原发性乳腺癌的风险,分子亚型和预后:基于第一种原发性癌症的分析
Chaofan Li1, Chong Du1, Yusheng Wang2
1Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University No. 157 West Fifth Street, Xi'an, Shaanxi, P. R. China.
American journal of cancer research
|August 10, 2023
概括
第二种原发性乳腺癌 (SPBC) 在癌症幸存者中更为常见,并且与特定的第一种原发性癌症有关. 一般来说,SPBC的生存率较差,但甲状腺癌后的预后更好,为生存率开发了一个预测模型.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 癌症研究 癌症研究
背景情况:
- 第二种原发性乳腺癌 (SPBC) 的发生和预后受先前恶性瘤的影响,但详细的表征仍然有限.
- 了解SPBC和第一原发性癌症 (FPC) 之间的关系对于完善发病率,预后和治疗策略至关重要.
研究的目的:
- 调查SPBC与FPC相关的发病率,模式和临床特征.
- 为了比较SPBC患者与原发性乳腺癌 (PBC) 患者的整体存活率和乳腺癌特异性存活率.
- 开发一个预测模型来估计SPBC患者的生存率.
主要方法:
- 对SPBC患者标准化发病率 (SIR) 和标准化死亡率 (SMR) 的分析.
- 倾向性得分匹配 (PSM) 以平衡SPBC和PBC队列之间的临床特征.
- 卡普兰-梅尔 (KM) 总和乳腺癌特异性生存率的生存分析.
- 开发一种极端梯度提升 (XGBoost) 模型,用于生存预测.
主要成果:
- 在癌症幸存者中,SPBC发生率显著高于癌症幸存者 (SIR=1.16).
- 第一次原发性肺/支气管癌的SPBC患者的死亡率较高 (SMR=1.71).
- 在SPBC中,HR-/HER2-亚型的比例更高,尤其是在依赖雌激素的癌症之后.
- SPBC的总生存率低于PBC (HR=1.43),除了第一种甲状腺癌的幸存者 (HR=0.64).
- 在XGBoost模型中,AUC为0.817的3年生存率和0.825的5年生存率.
结论:
- 第一次原发性癌症显著影响SPBC的发展和独特的生物性能.
- 根据FPC,SPBC的预后有所不同,甲状腺癌后改善的生存率是一个显著的例外.
- 该研究为SPBC患者的临床随访和鉴定策略提供了理论基础.
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