化生性乳腺癌预后影响因素分析与预后模型构建

目的:分析对比中国和美国化生性乳腺癌(metaplastic breast carcinoma,MBC)患者的临床病理特征和预后影响因素，并构建列线图来预测MBC患者的3年和5年生存率。方法:以SEER数据库中提取的673例患者作为建模集，采用Cox等比例回归模型分析确定MBC的独立预后因素，然后将这些因素纳入并构建列线图模型，然后以我院的36例MBC患者作为验证集进行外部验证。结果:建模集和验证集的临床病理特征除年龄、肿瘤分级、是否第一原发肿瘤及N分期外无明显差异。单因素及多因素分析结果显示，所有患者中，年龄、是否化疗、T分期、N分期以及M分期均是MBC患者预后的独立危险因素。将这些因素纳入并建立列线图预测模型。结论:列线图能准确预测我国MBC患者的预后情况，为临床的诊疗提供科学依据。

Analysis of prognostic factors and construction of prognostic models for metaplastic breast carcinoma

Objective:To analyze pathological character and prognosis factors of Chinese and American metaplastic breast carcinoma(MBC) patients,and construct a nomogram for forecasting 3-year and 5-year overall survival (OS).Methods:673 patients extracted from SEER database were used as modeling set,and 36 patients with MBC in our hospital were used as the validation set.The clinical baseline characteristics of patients in modeling set and validation set were compared,and the independent risk factors for the overall survival(OS) were screened by Cox equal proportional regression model.Based on the results of multiple regression analysis of the modeling set Cox model,the nomogram models for predicting the OS were constructed.Results:There were no significant differences in the baseline characteristics between the patients in modeling set and validation set except age,grade,whether first primary tumor and N staging.The results of analysis showed that age,chemotherapy,T staging,N staging and M staging were independent risk factors for OS in MBC patients.Based on the above variables,the nomogram models were constructed and evaluated.Conclusion:A nomogram can accurately predict the prognosis of MBC patients in China and provide scientific basis for clinical diagnosis and treatment.