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A model for evaluating the prognosis of patients with Paget's disease and invasive ductal carcinoma and its application

An invasive and patient-friendly technology, which is applied in the field of models to evaluate the prognosis of breast Paget's disease patients with invasive ductal carcinoma, can solve the problem of inaccurate prognosis of PD-IDC population, and achieve the effect of efficient treatment plan and easy operation

Active Publication Date: 2022-03-08
SUN YAT SEN MEMORIAL HOSPITAL SUN YAT SEN UNIV
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

Therefore, predicting the prognosis of the PD-IDC population is not accurate enough

Method used

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  • A model for evaluating the prognosis of patients with Paget's disease and invasive ductal carcinoma and its application
  • A model for evaluating the prognosis of patients with Paget's disease and invasive ductal carcinoma and its application
  • A model for evaluating the prognosis of patients with Paget's disease and invasive ductal carcinoma and its application

Examples

Experimental program
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Effect test

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 breast Paget's disease with invasive ductal carcinoma, including a nomogram for evaluating the specific survival probability of the patient after 5 years and the prognosis risk of Paget's disease with invasive ductal carcinoma Scoring formula. The nomogram in the present invention is the only survival prediction model established for the first time for the PD-IDC population, and the PD-IDC model can more accurately predict the survival prognosis of this type of special population; it is confirmed in the present invention that its prediction performance is better than the other two (AJCC staging and NPI grading); secondly, the PD-IDC nomogram in the present invention is concise, easy to understand, and is convenient for clinicians and patients to operate themselves, predicting 5-year and 10-year breast cancer-specific survival rates; at the same time The patient score calculated according to the risk score formula in the model of the present invention can clearly distinguish high-risk and low-risk groups, thereby assisting clinicians to formulate an efficient treatment plan.

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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Patent Type & Authority Patents(China)
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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