探索最适合的淋巴结分期系统,以节点阳性乳腺癌患者,并构建相应的生存名ograms
Xiao Huang1, Xiangnan Xu2, An Xu1
1Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.
Journal of cancer research and clinical oncology
|August 16, 2023
概括
对于乳腺癌患者来说,最好的淋巴结分期系统取决于去除的淋巴结的数量. 新的诺姆图准确地预测生存和帮助治疗决策.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
- 癌症预后 癌症预后
背景情况:
- 淋巴结 (LN) 状态是乳腺癌 (BC) 患者的关键预后指标.
- 准确的LN分期对于预测患者的结果和指导治疗策略至关重要.
- 现有的分期系统可能有不同的预测能力,这取决于患者的特征.
研究的目的:
- 为了比较三个淋巴结分期系统的预测性能:pN阶段,淋巴结比率 (LNR) 和阳性淋巴结的日志几率 (LODDS).
- 开发和验证名录模型,用于预测节点阳性乳腺癌患者的整体存活率 (OS).
- 为了确定最佳分期系统是否根据移除的淋巴结 (RLNs) 的数量而有所不同.
主要方法:
- 来自SEER数据库的大型队列 (71,213名患者) 的分析,使用667例医院病例进行外部验证.
- 根据移除的淋巴结数量 (RLNs < 10 和 RLNs ≥ 10),患者被分为两组.
- 使用C指数和AUC值来评估预后能力;LASSO回归确定了名ogram发展的显著预后因素.
主要成果:
- 当RLN<10时,LNR表现出比pN和LODDS更好的预测性能.
- 当RLN≥10时,pN阶段显示出更好的预测能力.
- 在培训和验证队伍中,开发的诺莫格拉姆模型表现出卓越的临床适用性,准确性和区别性.
结论:
- 乳腺癌中淋巴结分期系统的选择应以移除的淋巴结的数量为指导.
- 整合关键预后因素的新型名录显示出预测整体存活率的高性能.
- 这些经过验证的名图可以帮助临床医生在患者咨询和优化治疗决策.
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