Model for evaluating prognosis of patients with Paget's disease and invasive ductal carcinoma and application thereof

An invasive, patient-based technology, applied in the field of models for evaluating the prognosis of patients with Paget's disease of the breast and invasive ductal carcinoma, can solve the problems of inaccurate prognosis in the PD-IDC population, and achieve the effect of efficient treatment plan and easy operation.

Active Publication Date: 2019-03-19
SUN YAT SEN MEMORIAL HOSPITAL SUN YAT SEN UNIV
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

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Problems solved by technology

Therefore, predicting the prognosis of th

Method used

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  • Model for evaluating prognosis of patients with Paget's disease and invasive ductal carcinoma and application thereof
  • Model for evaluating prognosis of patients with Paget's disease and invasive ductal carcinoma and application thereof
  • Model for evaluating prognosis of patients with Paget's disease and invasive ductal carcinoma and application thereof

Examples

Experimental program
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Embodiment 1

[0033] An embodiment of a method for constructing a prognostic model for assessing breast Paget's disease with invasive ductal carcinoma in the present invention comprises the following steps:

[0034](1) Modeling crowd screening:

[0035] A total of 2502 patients diagnosed with PD-ICD between 1988 and 2015 were included in the study cohort. The median follow-up time was 77 months, and the mean follow-up time was 92.9 months. By the study cutoff date, 477 patients with PD-IDC had died from breast cancer-related causes and 344 patients had died from other causes. The inclusion and exclusion criteria for this part of the population were: exclusion of stage IV breast cancer, exclusion of patients with incomplete records of clinicopathological information, exclusion of inflammatory breast cancer, and exclusion of patients who were followed up for less than 6 months after diagnosis.

[0036] (2) Index establishment: In the study cohort, 10.31% had T4 tumors, of which 8 (3.1%) wer...

Embodiment 2

[0047] Embodiment 2 calibration curve and C index are used to verify the predictive accuracy of model in embodiment 1

[0048] The C index ranges from 0 to 1, and greater than 0.5 indicates that the model has a better discrimination, and the closer to 1, the better the discrimination of the model. Based on the patient population data screened in Example 1, the inventors used the Bootstrap method for internal validation of the model in Example 1, wherein 500 random samples were replaced 1000 times from the original data set, and the C index was recalculated and corrected with 1000 iterations. After verification, the average C index is 0.739 (95% CI, 0.692-0.746), suggesting that the model of Example 1 has good discrimination. The inventors then plotted calibration curves of predicted and observed 5- and 10-year survival using 1000 bootstrap runs.

[0049] image 3 The predicted 5-year survival probability and the patient's real 5-year survival probability, the abscissa is the...

Embodiment 3

[0050] Example 3 Comparing the PD-IDC nomogram of Example 1 with AJCC staging and NPI grading

[0051] Based on the patient population data screened in Example 1, the inventors compared the PD-IDC nomogram of Example 1 with the AUC (area under the receiver operating curve) between the AJCC staging and NPI grading, and the NPI grading predicted 5 years respectively and 10-year BCSS. Furthermore, a C-index is calculated to compare the performance of the three forecasting methods.

[0052] The predicted results show that the C index of the PD-IDC nomogram is 0.791 (95% CI, 0.783-0.818), the AJCC stage is 0.718 (95% CI, 0.695-0.741), and the NPI classification is 0.691 (95% CI, 0.650 -0.735). The C index of PD-IDC was significantly better than that of AJCC staging (P=0.000) and NPI classification (P=0.000).

[0053] Figure 5 In the figure, the light gray solid line is the ROC curve of the PD-IDC nomogram, the black solid line is the ROC curve of the AJCC staging, and the dott...

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Abstract

The invention discloses a model for evaluating the prognosis of patients with Paget's disease and invasive ductal carcinoma, which comprises a line graph for evaluating the specific survival probability of the patients after five years and a prognosis risk score formula of the patients with Paget's disease and invasive ductal carcinoma. The line graph is the only survival prediction model established for the PD-IDC crowd for the first time, and the PD-IDC model can more accurately predict the survival prognosis of the special crowd; according to the model, the prediction efficiency is better than the prediction efficiency of the other two (AJCC staging and NPI grading) ; secondly, the PD-IDC line graph is concise and easy to understand, the operation for a clinician and a patient is convenient, and the model can predict the specific survival probability of breast cancer for 5 years and 10 years; meanwhile, the patient score calculated according to the risk score formula in the model can clearly distinguish high-risk and low-risk people so as to assist clinicians to formulate high-efficiency treatment schemes.

Description

technical field [0001] The invention relates to the technical field of prognosis assessment of patients with invasive ductal carcinoma, in particular to a model for assessing the prognosis of breast Paget's disease patients with invasive ductal carcinoma and its application. Background technique [0002] Paget's disease (PD) of the breast was first reported by Velpeau in 1856, and then in 1874 James Paget described a group of syndromes, including erythema, eczema, ulcers, bleeding and itching in the nipple areola area, and named it PD. PD is relatively rare, accounting for 1-3% of all breast malignancies. In up to 82% to 93% of PD patients, PD is associated with underlying invasive ductal carcinoma (IDC) or ductal carcinoma in situ (DCIS). The diagnosis of breast PD is characterized by histopathological infiltration of ballooning neoplastic Paget's cells. So far, the pathogenesis of PD is still controversial. The more widely accepted theory is the migration theory, whereb...

Claims

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Application Information

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IPC IPC(8): G16H50/20G16H50/70
CPCG16H50/20G16H50/70
Inventor 龚畅谭璐媛
Owner SUN YAT SEN MEMORIAL HOSPITAL SUN YAT SEN UNIV
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