在老年患者中评估高风险乳腺癌:对PREDICT评分和TAILORx风险分类进行比较分析
Çağlar Ünal1, Tolga Özmen2,3, Çetin Ordu4
1Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey.
European journal of breast health
|October 5, 2023
概括
这项研究发现,较低的孕激素受体 (PR) 水平,而不是PREDICT得分,显著预测了老年患者高风险的早期乳腺癌. 结合PREDICT,PR级别和TAILORx等工具,有助于进行全面的风险评估.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 生物统计学 生物统计学
背景情况:
- 在老年患者中,早期的乳腺癌管理需要准确的风险分层.
- 激素受体 (HR) 阳性,人体表皮生长因子受体2 (HER2) 阴性早期乳腺癌患者组成了一个重要的亚组.
- 对于老年人群,现有的风险评估工具可能需要改进.
研究的目的:
- 评估PREDICT工具总生存率 (OS) 评分和TAILORx在老年HR+/HER2-早期乳腺癌中高风险患者分类之间的关系.
- 为了确定PREDICT得分和孕激素受体 (PR) 水平在这个人口中具有高风险状态的预测价值.
主要方法:
- 在2017-2022年期间,对64名患有早期乳腺癌的老年患者 (65-75岁) 进行了回顾性分析.
- 从医疗记录中提取的数据,包括型Dx复发得分和通过PREDICT工具计算的10年OS率.
- 根据TAILORx.的定义,低风险和高风险群体之间的PREDICT分数和PR水平的比较.
主要成果:
- 低风险患者的PREDICT分数略高 (78%对73%,81%对77%),具有统计学意义.
- 在高风险组中,孕激素受体 (PR) 水平显著降低 (3.5%对80%).
- 单元降低PR水平与增加高风险几率 (多变量分析中为5%) 显著相关,而PREDICT评分变化在统计学上并不显著.
结论:
- 孕激素受体 (PR) 水平是老年患者高风险早期乳腺癌的重要预测因素,比PREDICT工具得分更重要.
- 结合PREDICT工具,PR级别和TAILORx风险分类,可以为老年人提供更全面的风险评估.
- 建议在更大的队列中进一步验证和探索额外的生物标志物,以优化老年人乳腺癌管理.
相关概念视频
Comparing the Survival Analysis of Two or More Groups
206
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
206
Cancer Survival Analysis
365
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
365
Receiver Operating Characteristic Plot
269
A ROC (Receiver Operating Characteristic) plot is a graphical tool used to assess the performance of a binary classification model by illustrating the trade-off between sensitivity (true positive rate) and specificity (false positive rate). By plotting sensitivity against 1 - specificity across various threshold settings, the ROC curve shows how well the model distinguishes between classes, with a curve closer to the top-left corner indicating a more accurate model. The area under the ROC curve...
269
Relative Risk
195
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
195
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
137
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
137
Hazard Ratio
142
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
142


