乳腺恶性分叶状肿瘤患者预后列线图构建及验证

Construction and Verification of a Prognostic Nomogram for Patients with Malignant Phyllodes Tumors of the Breast

目的构建乳腺恶性分叶状肿瘤(MPT)预后列线图,并验证其效能。预测MPT患者1、3和5年生存率。方法以美国国立癌症研究所的监测、流行病学和结局(SEER)数据库中2004—2015年有完整数据记录的508例MPT患者为研究对象,随机分为建模组(356例)和验证组(152例),对建模组进行单因素和多因素Cox回归分析,将预后指标纳入列线图的构建并检验模型的准确性。结果列线图模型共纳入年龄、肿瘤大小、肿瘤级别、N分期、M分期5个预后影响因素,建模组与验证组的一致性指数分别为0.845(95%CI:0.802~0.888)和0.784(95%CI:0.688~0.880)。结论本研究构建的列线图具有良好的预测价值,可对乳腺恶性分叶状肿瘤患者1、3和5年生存率做出较准确的评估,为患者预后判断提供理论依据。

Objective To construct a prognostic nomogram for patients with malignant phyllodes tumors(MPT)of the breast and verify its efficacy,and to predict the 1-year,3-year and 5-year survival rates of MPT patients.Methods Tale 508 MPT patients with complete data records from 2004 to 2015 from the National Cancer Institute’s Surveillance,Epidemiology,and Outcome Database(SEER)as the research object,who were randomly divided into the modeling group(356 cases)and the validation group(152 cases),single-factor and multi-factor Cox regression analysis were performed on the modeling group,the prognostic indicators were included in the construction of the nomogram and the accuracy of the model was tested.Results The nomogram model included five prognostic factors including age,tumor size,tumor grade,N stage,and M stage.The consistency indexes of the modeling group and the validation group were 0.845(95%CI:0.802-0.888)and 0.784(95%CI:0.688-0.880)respectively.Conclusion The nomogram constructed in this study has good predictive value.It can make a more accurate assessment of the 1-year,3-year and 5-year survival rates of patients with breast malignant phyllodes tumors.The prognostic judgment of patients provides a theoretical basis.