评估预测,一个预后风险工具,在诊断了第二次乳腺癌后
Zhengyi Deng1, Miranda R Jones2,3, Antonio C Wolff3
1Stanford School of Medicine, Palo Alto, CA, USA.
JNCI cancer spectrum
|September 29, 2023
概括
预测工具低估了乳腺癌死亡率的第二次原发性癌症,特别是雌激素受体阳性类型. 需要对特定子组进行进一步评估,以确保所有乳腺癌患者的预后准确.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
- 临床预后 临床预后
背景情况:
- 英国国家卫生服务的预测工具是为估计早期乳腺癌预后而建立的.
- 它在预测第二种原发性乳腺癌的结果方面的表现仍未得到评估.
研究的目的:
- 评估Predict工具的准确性和校准性,用于估计患有第二种原发性乳腺癌的妇女与患有第一种原发性乳腺癌的妇女的5年乳腺癌特定死亡率.
- 评估Predict工具在不同雌激素受体状态,种族,种族和年龄组的性能.
主要方法:
- 利用来自美国监测,流行病学和最终结果 (SEER) 数据库的数据,对2000-2013年间诊断的妇女进行了至少5年的随访.
- 对比预测与观察到的5年乳腺癌特异性死亡率,以第一种乳腺癌和第二种乳腺癌为例,按雌激素受体状态分层.
- 使用接收机运行特征曲线和曲线下的面积来评估模型歧视.
主要成果:
- 预测证明了第一种和第二种乳腺癌的良好歧视 (AUC 0.73-0.82).
- 该工具显著低估了第二种雌激素受体阳性乳腺癌的5年死亡率 (预测观察 -6.24%).
- 对于第二种雌激素受体阴性癌症,它低估了特定亚组 (例如,先前化疗) 的死亡率,而对第一种雌激素受体阴性癌症则高估了.
结论:
- 预测工具低估了第二种雌激素受体阳性乳腺癌的5年死亡率.
- 在第二种雌激素受体阴性乳腺癌的特定亚组中注意到了性能变化,这表明了潜在的偏差.
- 预测工具可能需要进行校准调整,以提高不同乳腺癌群体的准确性.
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