淋巴结阴性乳腺癌预后、预测因素及其数学模型的建立

Prognostic and predictive factors in lymph node negative breast cancer and establishment of mathematical model

目的:利用淋巴结阴性乳腺癌病人的临床病理和实验室指标来估计病人的预后、决定辅助治疗的方式与效果,将病人的预后、预测因素及治疗方式对淋巴结阴性的乳腺癌病人预后影响进行综合评估,建立淋巴结阴性乳腺癌病人的预后模型。方法:按照Nottingham指数的建立原理,对有关资料进行Cox模型分析(半参数多因素生存分析),从中建立预后指数模型并予以验证。结果:多因素分析发现年龄、肿瘤大小、HER-2表达、ER与内分泌治疗相互作用、化疗将独立地影响预后;并建立预后数学模型指数评分公式:PS=Size+Her2-2.5×age-CT-O.55×(ET×ER)。结论:该模型对病人决定治疗前判断其复发概率,亦可在决定某种辅助治疗时前瞻性地预测其治疗后的复发概率。

Purpose: Comprehensively assess the role of prognostic and predictive factors and set up a mathematical model to evaluate prognosis and to help the decision of adjuvant therapy. Methods: All prognostic indicator and therapeutic modalities have been performed, mutivariate survival analyses was done by Cox regression. The split-group method was used to construct the mathematical model for prognosis. Results: In multivariate analysis, the factors including age, tumor size, overexpression of Her-2, the interaction between ER status and endocrine therapy (ER ET), and chemotherapy can independently predict prognosis. Finally, the mathematical model acquired is PS = Size + Her2 -2. 5 x age - CT -0. 55 x ( ET x ER). Conclusions: According to PI of individuals, the different risks of failure can been distinguished.