基于血清CA50、TSGF、TPA的中晚期乳腺癌放化疗敏感性列线图预测模型的建立与评价OA北大核心CSTPCD
Establishment and evaluation of the model for predicting the sensitivity to radiochemotherapy in patients with middle-and advanced-stage breast cancer based on serum CA50,TSGF,and TPA
目的 探究血清糖类抗原50(CA50)、肿瘤特异性生长因子(TSGF)、组织多肽抗原(TPA)表达对中晚期乳腺癌放化疗敏感性的预测价值,通过建立列线图模型进行验证与评价.方法 选取82例中晚期乳腺癌患者为研究对象,所有患者均接受紫杉醇化疗联合放疗,根据实体瘤疗效评价标准分为敏感组(n= 57)和不敏感组(n= 25).统计2组患者的一般资料,治疗前后血清CA50、TSGF、TPA表达水平及差值,构建列线图模型,绘制校准曲线、受试者操作特征(ROC)曲线、决策曲线,评估列线图模型的预测效能和临床效用.结果 2组比较,肿瘤直径、脉管侵犯、TNM分期、淋巴结转移、分化程度的差异有统计学意义(P＜0.05).治疗后不敏感组血清CA50、TSGF、TPA表达水平高于敏感组,CA50、TSGF、TPA差值低于敏感组(P＜0.05).将上述有统计学差异的因素纳入LASSO回归,选出3个预测变量,分别为CA50、TSGF、TPA差值.logistic回归显示,CA50、TSGF、TPA差值是中晚期乳腺癌放化疗敏感性的影响因素(P＜0.05);基于CA50、TSGF、TPA差值构建列线图模型,校准曲线、ROC曲线、决策曲线显示该模型具有良好的预测精准度和临床效用.结论 中晚期乳腺癌放化疗不敏感的患者治疗后血清CA50、TSGF、TPA表达水平较高,且三者差值是影响放化疗敏感性的因素.基于血清CA50、TSGF、TPA构建的列线图预测模型具有良好的预测价值和临床效用.
Objective To evaluate the predictive value of serum carbohydrate antigen 50(CA50),tumor specific growth factor(TSGF),and tissue polypeptide antigen(TPA)levels for sensitivity to radiochemotherapy in patients with middle-and advanced-stage breast cancer using a nomogram model.Methods Eighty-two patients with middle-and advanced-stage breast cancer were selected as the study sub-jects.All patients received paclitaxel chemotherapy combined with radiotherapy and were divided into sensitive(n= 57)and insensitive(n= 25)groups according to the Response Evaluation Criteria in Solid Tumors.The general information of the patients,serum expression of CA50,TSGF,and TPA,and their differences before and after treatment were recorded.A nomogram model was constructed,and cali-bration curves,receiver operating characteristic(ROC)curves,and decision curves were used to evaluate the predictive power and clinical utility of the nomogram model.Results Significant differences were observed in tumor diameter,vascular invasion,TNM stage,lymph node metastasis,and degree of differentiation between the two groups(P＜0.05).Compared to those in the sensitive group,the serum expression of CA50,TSGF,and TPA after treatment was higher,and the difference in CA50,TSGF,and TPA was smaller in the insensitive group(P＜0.05).Three predictive variables were identified in the LASSO regression:differences in CA50,TSGF,and TPA.The logistic regression results showed that differences in CA50,TSGF,and TPA influenced sensitivity to radiochemotherapy in middle-and advanced-stage breast cancer(P＜0.05).A nomogram model was constructed using differences in CA50,TSGF,and TPA.Calibration,ROC,and decision curves showed the model's good predictive accuracy and clinical utility.Conclusion Serum expression of CA50,TSGF,and TPA is high in patients with middle-and advanced-stage breast cancer who are insensitive to radiochemotherapy,and differences in CA50,TSGF,and TPA affect their sensitivity to radiochemotherapy.The nomogram model had good predictive value and clinical utility.
陈国华;张浩宇;韩升波;何建鑫
郑州市中医院检验科,郑州 450000
临床医学
糖类抗原50肿瘤特异性生长因子组织多肽抗原中晚期乳腺癌放化疗敏感性列线图模型
carbohydrate antigen 50tumor specific growth factortissue polypeptide antigenmiddle-and advanced-stage breast cancersensitivity to radiochemotherapynomogram model
《中国医科大学学报》 2024 (003)
240-245 / 6
河南省医学科技攻关计划(联合共建)项目(LHGJ20190514)
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