目的:利用监测、流行病学和最终结果(surveillance，epidemiology，and end results，SEER)数据库构建列线图来预测老年早期HER2阳性乳腺癌患者的生存概率。方法:SEER数据库中筛选的5 220名(基于单靶向治疗时代)和1176名(基于双靶向治疗时代)患者被随机分为训练组和内部验证组。采用COX比例风险回归筛选生存相关预测因素并建立列线图模型，利用一致性指数(C-index)、校准曲线、受试者工作特征曲线(receiver operating characteristic curve，ROC)检验模型的准确性及实用性。对接受化疗和非化疗的患者使用两组倾向评分匹配进行统计配对，并对筛选的变量进行亚组分析。结果:单靶治疗时代列线图是由七个变量构建:年龄、婚姻状态、T分期、N分期、手术、化疗、放疗。双靶治疗时代列线图由两个变量构建:化疗和放疗。亚组分析结果表明，接受化疗的老年HER2阳性乳腺癌患者有更好的总生存期(OS)。结论:基于SEER数据库，建立并验证了预测老年早期HER2阳性乳腺癌患者生存率的准确列线图。该研究表明，化疗能增加老年患者的生存获益。
Construction of a column-line graph for predicting the probability of survival in early-stage elderly HER2-positive breast cancer based on the SEER database
AIM:To construct column-line plots to predict survival in elderly patients with early-stage HER2-positive breast cancer using the Surveillance,Epidemiology and End Results(SEER)database.METHODS:5 220(based on the era of single-target-ed therapy)and 1 176(based on the era of dual-targeted therapy)patients screened in the SEER da-tabase were randomized into a training group and an internal validation group.COX proportional risk regression was used to screen survival-related pre-dictors and build a column-line graphical model,and the accuracy and utility of the model were test-ed using the consistency index(C-index),calibra-tion curves,and time-dependent ROC curves.Pa-tients receiving chemotherapy and non-chemother-apy were statistically paired using two-group pro-pensity score matching,and subgroup analyses were performed on the screened variables.RE-SULTS:The single-targeted therapy era line graph was constructed from seven variables:age,marital status,T-stage,N-stage,surgery,chemotherapy,and radiotherapy.The dual-targeted therapy era line graph was constructed from five variables:age,AJCC staging,surgery,chemotherapy,and radio-therapy.The results of the subgroup analysis showed that older HER2-positive breast cancer pa-tients who received chemotherapy had better OS.CONCLUSION:Based on the SEER database,an ac-curate column-line graph predicting survival in el-derly patients with early-stage HER2-positive breast cancer was established and validated.This study suggests that chemotherapy increases surviv-al benefit in elderly patients.
HER2-positive breast cancernomo-gramchemotherapySEER database
国家科技期刊平台
NSTL
万方数据
