| Research Background:Triple-negative metapalstic breast cancer(TN-MBC)is a very rare subtype of breast cancer.It is characterized by high degree of malignancy,strong invasion and poor prognosis.However,there are few studies on tn-mbc at home and abroad,and there is no completely unified conclusion on its diagnosis,treatment and prognosis.The purpose of this study is to determine the relevant risk factors affecting the prognosis of TN-MBC and establish a perfect and reliable nomogram risk prediction model,so as to provide a more comprehensive basis for clinical treatment and prognosis.Research Methods:From the surveillance,epidemiology,and end results(SEER)database supported by the National Cancer Institute(NCI),we screened 799 tn-mbc patients who met the requirements from 2010 to 2018.According to the method of random grouping,they were divided into modeling group(n = 599)and experimental module(n = 200).The final selection included age,race,marital status,gender Histological grade,tumor location,surgery,chemotherapy,radiotherapy,tumor size,distant metastasis and lymph node metastasis may be 12 risk factors related to the prognosis of tn-mbc patients.Cox proportional hazards regression model was used to analyze the related factors in the modeling group.According to the meaningful statistics in the results(P< 0.05),the independent risk factors affecting the overall survival rate(OS)were determined.Then the relevant risk factors were substituted into the model to construct a nomogram prediction model for evaluating the 3-year and 5-year OS of tn-mbc patients.Then,in the modeling group and verification module,the model is verified by drawing the calibration curve,calculating the consistency index(c-index),drawing the receiver operating characteristic(ROC)and calculating the area under the curve(AUC),so as to test the performance of the model.Finally,Kaplan Meier survival analysis was used to draw and test the survival curve of different risk groups provided in nomogram prediction model.Results:Among Cox univariate and multivariate results,there were significant differen-ces in age,race,surgery,chemotherapy,tumor size,distant metastasis and lymph node metastasis(P < 0.05).These seven variables can be considered as independent risk factors affecting the prognosis of tn-mbc patients.Therefore,we incorporated these seven variables into nomogram prediction model.In the process of model validation,the calibration curves of the modeling group and the test module showed that the predicted 3-year and 5-year overall survival rate of the model was almost consistent with the actual survival rate.In addition,the consistency indexes of the modeling group and the experimental module were 0.744 and 0.786 respectively,and the areas under the curve of the 3-year and 5-year overall survival rate(OS)of the modeling group and the experimental module were 0.765,0.763,0.819 and 0.819 respectively.Next,each patient was scored according to the nomogram risk prediction model established by the modeling group,and the boundary value was determined according to the score.After substituting it into the test module,the Kaplan Meier survival curve of different risk groups in tn-mbc patients was obtained and meaningful results were obtained(P < 0.05).The above results show that the nomogram prediction model constructed in this study has high accuracy and good performance.Conclusion:(1)in Triple-negative metapalstic breast cancer,age,race,surgery,chemotherapy,tumor size,distant metastasis and lymph node metastasis are independent risk factors for long-term survival.(2)In this study,the nomogram prediction model based on multiple clinicopatho-logical factors has quite high accuracy.It can provide more comprehensive prognosis judgment and better treatment decision-making in clinic. |
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