Prediction of postoperative survival of triple-negative breast cancer based on nomogram model combined with expression of HIF-1α and c-myc
Autor: | Hongchuan Jiang, Jianxiu Cui |
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Rok vydání: | 2019 |
Předmět: |
Oncology
Adult medicine.medical_specialty Multivariate analysis Breast surgery medicine.medical_treatment Genes myc Observational Study HIF-1α Triple Negative Breast Neoplasms nomogram 03 medical and health sciences 0302 clinical medicine Breast cancer c-myc Internal medicine medicine Biomarkers Tumor Humans 030212 general & internal medicine Lymph node Triple-negative breast cancer Neoplasm Staging Proportional hazards model business.industry Age Factors General Medicine Nomogram Middle Aged medicine.disease Hypoxia-Inducible Factor 1 alpha Subunit Prognosis Tumor Burden medicine.anatomical_structure 030220 oncology & carcinogenesis Lymphatic Metastasis triple-negative breast cancer Female Neoplasm Grading business Research Article |
Zdroj: | Medicine |
ISSN: | 1536-5964 |
Popis: | The aims of this study were to explore the expression of hypoxia inducible factor-1α (HIF-1α) and c-myc protein in triple-negative breast cancer (TNBC) and its clinical prognostic significance, and to establish a prediction model for postoperative survival of TNBC based on nomogram. A total of 87 patients with TNBC at the Department of Breast Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2012 to December 2015 were enrolled in this study. Immunohistochemistry was performed to detect the expression of HIF-1α and c-myc protein in breast cancer tissues. Cox regression analyses were performed to explore the correlation between HIF-1α/c-myc expression and clinical pathological parameters as well as prognosis. Receiver-operating characteristic curve was generated for cox multivariate analysis. A nomogram was generated based on the cox multivariate analysis, and a calibration curve was prepared for the nomogram to evaluate the consistency between the predicted probability of the nomogram and the actual observed probability. The stability of nomogram model was validated with an external cohort including 39 TNBC patients. The positive expression rates of HIF-1α and c-myc protein in breast cancer tissues were 41.4% (36/87) and 55.2% (48/87), respectively. HIF-1α expression was significantly correlated with age, tumor diameter, histological grade, lymph node status, and tumor TNM stage; c-myc expression was significantly associated with tumor diameter, histological grade, lymph node status, and tumor TNM stage. Cox univariate and multivariate analyses showed that HIF-1α and c-myc protein expression, histological grade, lymph node status, and tumor TNM stage were the independent risk factors for postoperative survival in TNBC patients. The AUC of prediction model was 0.843 (0.809–0.887). The nomogram could predict the probability of 3-year disease-free survival according to each patient's condition. The calibration curve displayed good agreement of the predicted probability with the actual observed probability, indicating that the nomogram model had great value of prediction. The external validation indicated the prediction model had good stability. HIF-1α-positive expression, c-myc positive expression, histological grade III, lymph node positive, and TNM stage III tumors suggested that TNBC patients had a poor prognosis. This prediction model can be used to predict postoperative survival of TNBC. |
Databáze: | OpenAIRE |
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