转化医学杂志2025，Vol.14Issue(6)：13-19,7.DOI:10.3639/j.issn.2095-3097.2025.06.003
三阴性乳腺癌患者放化疗疗效预测模型的建立与验证
Establishment and Verification of A Model for Predicting the Efficacy of Radiotherapy and Chemotherapy in Triple Negative Breast Cancer Patients
摘要
Abstract
Objective To analyze the factors influencing the efficacy of radiotherapy and chemotherapy in patients with triple-negative breast cancer and to build a nomogram prediction model.Methods A total of 260 patients with triple-negative breast cancer admitted to Tangshan People's Hospital from October 2022 to January 2024 were prospectively selected.They were randomly divided into a modeling set(182 cases)and a validation set(78 cases)in a 7:3 ratio.Based on the therapeutic effects of radiotherapy and chemotherapy,patients in the modeling set were divided into a remission group(n=66)and a non-re-mission group(n=116).Multivariate logistic regression was used to analyze factors affecting treatment efficacy,and the predic-tion model was constructed using R software.Internal validation was performed via the bootstrap method.Receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)were generated to evaluate the model's pre-dictive performance,accuracy,and clinical net benefit.Results The effective remission rate after radiotherapy and chemother-apy was 35.00%in triple-negative breast cancer patients.No significant differences were observed between the remission and non-remission groups in body mass index,menstrual status,site of disease,histological grade,or axillary lymph node status at initial diagnosis(P>0.05).In remission group,patients aged≤40 years,TNM stageⅢ,high Ki-67 expression ratio,maximum tumor diameter,and CA153 level were significantly lower than those in the non-remission group(P<0.05),while the propor-tion of high-density tumor-infiltrating lymphocytes(TILs)was higher(P<0.05).Logistic regression analysis identified age≤40 years,TNM stageⅢ,high Ki-67 expression,large tumor diameter,elevated CA153 levels,and low TIL density as independent risk factors for ineffective radiotherapy and chemotherapy(P<0.05).The modeling set and validation set showed areas under the curve(AUC)of 0.804 and 0.771,respectively.Hosmer-Lemeshow test results for both groups indicated good fit(P>0.05).DCA demonstrated substantial clinical net benefit for both nomogram models.Conclusion This study identified six indicators in-fluencing radiotherapy and chemotherapy efficacy in triple-negative breast cancer patients.The risk prediction model based on these factors demonstrates strong clinical applicability and may guide clinical decision-making to improve remission rates.关键词
三阴性乳腺癌/放化疗/影响因素/列线图Key words
Triple-negative breast cancer/Chemoradiotherapy/Influencing factors/Nomograph分类
医药卫生引用本文复制引用
任宏媛,李春蕊,杜瑞..三阴性乳腺癌患者放化疗疗效预测模型的建立与验证[J].转化医学杂志,2025,14(6):13-19,7.基金项目
河北省医学科学研究重点课题计划(编号20181230) （编号20181230）
