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Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:

2023 11

Page:

2037-2041

Research Field:

Publishing date:

Info

Title:

The analysis of the factors affecting pathological complete response of HER-2 positive breast cancer patients after neoadjuvant chemotherapy and the construction of related model

Author(s):

YANG Liu¹; ZHANG Mingkun¹; JI Fuqing²; WANG Zhe¹; ZHANG Juliang¹

1.Department of Thyroid,Breast and Vascular Surgery,Xijing Hospital,Air Force Military Medical University,Shaanxi Xi'an 710032,China;2.Department of Thyroid and Breast,Xi'an No.3 Hospital,the Affiliated Hospital of Northwest University,Shaanxi Xi'an 710018,China.

Keywords:

HER-2 positive breast cancer; neoadjuvant chemotherapy; pathological complete response; nomogram

PACS:

R737.9

DOI:

10.3969/j.issn.1672-4992.2023.11.012

Abstract:

Objective£ºTo analyse the factors affecting pathological complete response(pCR) of human epidermal growth factor receptor 2(HER-2) positive breast cancer patients after neoadjuvant chemotherapy,and construct a nomogram to forecast the pCR rate.Methods£ºThe clinical and pathological data of 464 HER-2 positive patients received neoadjuvant chemotherapy in Xijing Hospital of Air Force Military Medical University from October,2017 to May,2021 were collected,which were set as modeling set.The clinical and pathological data of 91 HER-2 positive patients received neoadjuvant chemotherapy in Xi'an No.3 Hospital from January,2018 to May,2021 were collected,which were set as validation set.The clinical and pathological characteristics were compared between modeling set and validation set.In the modeling set,the independent risk factors of pCR in HER-2 positive patients after neoadjuvant chemotherapy were established by Lasso Logistic regression model analysis,and the nomogram model was constructed.External verification of the model was conducted in validation set.Internal validation of the model was conducted by Harrell's concordance index (C-index),receiver operating characteristic (ROC) analysis and area under curve(AUC).The accuracy of the model was evaluated by the calibration curve and the clinical benefits and application value of the model were evaluated by clinical decision curve analysis (DCA).Results£ºThere were significant difference in surgical method,chemotherapy regimens,hormone receptor(HR) status and T staging between the patients in modeling set and validation set£¨P£¼0.05).The results of analysis of Logistic regression model showed that N staging,targeted therapy regimens,HR status and clinical efficacy evaluation were independent risk factors of pCR in HER-2 positive breast cancer patients after neoadjuvant chemotherapy£¨P£¼0.05£©.Based on the above variables,the nomogram models were constructed.In modeling set,AUC=0.781£¨95%CI:0.734~0.827£©,in validation set,AUC=0.713£¨95%CI:0.635~0.859£©.The C-index for internal validation was 0.744.The calibration curve analysis showed that model predicted pCR rates had a good consistency with the actual observed values.In modeling set the Brier Score was 0.019 and in validation set the Brier Score was 0.043.The DCA showed that model can bring clinical benefit.Conclusion£ºThe nomogram can accurately predict the pCR rates of HER-2 positive breast cancer patients after neoadjuvant chemotherapy and provide scientific basis for clinical diagnosis and treatment.

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Memo

Memo:

National Natural Science Foundation of China(No.81902677£©£»¹ú¼Ò×ÔÈ»¿Æѧ»ù½ðÇàÄê¿Æѧ»ù½ðÏîÄ¿£¨±àºÅ£º81902677£©£»ÉÂÎ÷Ê¡ÖصãÑз¢¼Æ»®£¨±àºÅ£º2018ZDXM-SF-066£©

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Last Update: 2023-04-28