A nomogram prediction model of postoperative recurrence/metastasis of breast cancer based on the clinic-pathological-imaging combined model
10.3969/j.issn.1009-9905.2025.01.007
- VernacularTitle:临床-病理-影像联合模型构建乳腺癌术后复发/转移的列线图预测模型
- Author:
Hao HUANG
1
;
Li-hua ZHU
1
;
Jing TANG
1
;
Yong-jiang YU
1
;
Zhu-hong CUI
1
;
Jin LIU
1
Author Information
1. 四川省宜宾市第一人民医院 乳腺甲状腺外科(四川 宜宾 644000)
- Publication Type:Journal Article
- Keywords:
Breast cancer;
Recurrence and metastasis;
Magnetic resonance imaging(fmri);
Nomogram
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(1):34-39
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical significance of constructing a nomogram based on a combined model of clinical-pathological-imaging data for predicting postoperative recurrence/metastasis of breast cancer.Meth-ods:A retrospective study was conducted on 194 breast cancer patients who were admitted to the department of breast and thyroid surgery from June 2019 to June 2022.unvariate and multivariate Logistic regression analyses were used to screen independent predictors of postoperative recurrence/metastasis of breast cancer,and a model was con-structed based on the independent predictors.Another 83 breast cancer patients from July 2022 to February 2023 were taken as the validation set to verify the model with the ratio of 7∶3(training set∶validation set).Results:The postopera-tive recurrence/metastasis rate of breast cancer was 29.90％.Ki-67 expression level ≥20％,tumor location in the inner upper quadrant and outer upper quadrant,lesion size ≥20 mm,multiple lesions,and BI-RADS grade of 5 were indepen-dent risk factors for postoperative recurrence/metastasis of breast cancer(P＜0.05).PR positive expression was an inde-pendent protective factor for postoperative recurrence/metastasis of breast cancer(P＜0.05).The diagnostic performance of the combined clinical-pathological-imaging model(AUC:0.900)was superior to that of the clinical-pathological pa-rameters(AUC:0.655)and the MRI parameter model(AUC:0.857).In its nomogram model constructed based on a com-bined clinical-pathological-imaging model to predict breast cancer recurrence/metastasis after surgery,the AUC in the training set was 0.900(95％CI:0.859～0.942)with good discrimination,the maximum Yoden value was 0.710,the sensi-tivity was 0.931,and the specificity was 0.779,and the AUC in the validation set was 0.820(95％C/:0.712～0.928),well differentiated,with a maximum Yoden value of 0.554,a sensitivity of 0.630,and a specificity of 0.914.The theoretical and actual values of the calibration curves of the two sets were in good agreement,and the decision curve indicated the net benefit of the breast cancer recurrence-metastasis prediction model after surgery,which showed good predictive ability.Conclusion:The nomogram constructed based on the combined model of clinical-pathological-imaging data has good predictive ability,accuracy,and clinical applicability,which is helpful for clinicians to evaluate the risk of postoperative re-currence/metastasis of breast cancer.
