The Relationship Between Breast Cancer Bone Metastasis And Clinicopathological Characteristics And The Establishment Of Nomogram

Objective:1.Retrospectively analyze the clinicopathological characteristics of patients with breast cancer（BC）bone metastases and their relationship with the risk of breast cancer bone metastasis（BCBM）.2.Preliminary establishment of nomogram to predict the risk of bone metastasis in clinical patients.Methods:A retrospective collection of the clinical pathological characteristics of 137 patients with early breast cancer who were diagnosed for the first time in the Breast surgery Department of the First Affiliated Hospital of Nanchang University from January 2017 to January 2020.Among them,the diagnosis of breast cancer bone metastasis was confirmed by radionuclide bone scan and CT.There were 53 patients and 84 patients without bone metastasis.Using the random grouping method,137 patients with early breast cancer were randomly divided into a modeling group and a verification group.The modeling group accounted for 2/3,a total of 92 cases,and the verification group accounted for 1/3,a total of 45 cases.Use statistical software（Version SPSS 26）to conduct logistic risk factor correlation analysis on the relevant data collected by the modeling group.The significant statistically significant factors in the logistic single factor analysis result were included in the logistic multivariate regression analysis,and the significant statistically significant factors in the multivariate regression analysis were used to construct the nomogram prediction model using R software（Version 4.0.3）.The receiver operating characteristic curve（ROC）and the area below the Gi Vi TI calibration band are used to estimate the discriminativeness and calibration of the prediction model,respectively.Result:The collected 137 early breast cancer patients were divided into 92 cases in the modeling group and 45 cases in the verification group.The data in the modeling group was analyzed for risk factors.The logistic single factor analysis showed the size of breast masses,the multifocality of breast masses on color Doppler ultrasound,Color Doppler ultrasound axillary lymph node metastasis,whether the border of mammography target is regular,pathological type,T stage,N stage,AR,CA125,CA153,percentage of monocytes,percentage of neutrophils,CEA₂,CA153₂,percentage of monocytes₂,alkali Phosphatase₂ is an independent risk factor for bone metastasis of breast cancer（P<0.05）;logistic multivariate analysis showed that breast color Doppler ultrasound is multifocal,whether the mammography boundary is regular,pathological type,AR（≥10）,CA153（>25）,percentage of monocytes₂ is an independent risk factor for bone metastasis of breast cancer（P<0.05）.The nomogram model was constructed using multivariate analysis of statistically significant risk factors.The area under the ROC curve of the modeling group and the verification group were 0.950 and 0.865,respectively,indicating that the new prediction model has good discriminative ability;Gi Vi TI calibration of the two groups The P values of the bands are 0.812 and 0.327 respectively,and P>0.05 indicates that the prediction model has good calibration.Conclusion:Multifocal of color doppler ultrasound of breast,whether the borders of mammography targets are regular,pathological types,AR（≥ 10）、 CA153（>25）,percentage of monocytes₂ are independent risk factors for breast cancer bone metastasis.The nomogram model of early breast cancer patients can facilitate screening and early identification of bone Patients with higher risk of metastasis.