The influencing factors of recurrence and metastasisin invasive breast cancer patients undergoing chemo-therapy after modified radical surgery and the establishment of prediction model
Objective To study the influencing factors of recurrence and metastasis in patients with invasive breast cancer(IBC)undergoing chemotherapyafter modified radical surgery and establish a prediction model.Methods A total of 115 female IBC patients with recurrence and metastasis who underwent chemotherapy after modified radical surgery were selected as the recur-rence group,and another 115 patientscollected from 260 female IBC patients without recurrence and metastasis who underwent chemo-therapy after surgerywere enrolled as the control group according to the matching factor of follow-up timein 1∶1 ratio.The data such as de-mographic characteristics,tumor information,treatment process and follow-up results were collected and compared between the two groups.The influencing factors of postoperative recurrence and metas-tasis were analyzed by paired Logistic regression and a prediction model was established.In addition,102 female IBC patients who un-derwent modified radical surgery were randomly selected as the verifi-cation group.Hosmer-Lemeshow fit test and receiver operating charac-teristic(ROC)curve analysis model were used to predict the calibration degree and differentiation of postoperative recurrence and me-tastasis.Results Paired Logistic regression analysis showed that tumor diameter＞5 cm,high histological grade,axillary lymph node metastases≥4,negative ER/PR and failure to complete the prescribed cycle of chemotherapy were independent risk factors for postoper-ative recurrence and metastasis(P＜0.05),and postoperative targeted therapy was protective factor(P＜0.05).The prediction model was logit(P)=0.723×(tumor diameter＞5 cm)+0.515×(histological grade)+0.202×(axillary lymph node metastasis)+1.565×(ER/PR negative)-0.791×(postoperative targeted therapy)+0.980×(chemotherapy did not complete the prescribed cycle).Hosmer-Leme-show fit test showed good calibration(P＞0.05).The AUC of postoperative recurrence and metastasis predicted by Logistic regression model was 0.789(95％CI:0.729-0.849),sensitivity was 80.00％,and specificity was 73.90％.Conclusion Tumor diameter＞5 cm,high histological grade,number of axillary lymph node metastasis≥4,negative ER/PR,and failure to complete the prescribed cycle of chemotherapy are independent risk factors for recurrence and metastasis of IBC patients after modified radical surgery,and postopera-tive targeted therapy is a protective factor.The established Logistic regression model can provide effective reference information for pre-dicting the risk of postoperative recurrence and metastasis.
invasive breast cancermodified radical surgeryrecurrenceinfluencing factorspredictLogistic regression model
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