Clinicopathological Characteristics and Treatment Outcomes of Occult Breast Cancer: A Population-Based Study

2021 ◽  
Author(s):  
Zijun Zhao ◽  
Ting Zhang ◽  
Yu Yao ◽  
Xin Lu
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Large Population ◽  
Treatment Recommendation ◽  
Axillary Lymph ◽  
Occult Breast Cancer ◽  
Cox Regression Analysis ◽  
Breast Malignancy ◽  
Number Of Patients ◽  
Significant Difference

Abstract Background Occult breast cancer (OBC) is a special type of breast cancer. It is defined as an axillary lymph node metastasis without ipsilateral breast malignancy according to mammogram and ultrasonography. Because of its rarity and no primary lesion, clinicopathological information is still insufficient, causing a controversial condition about its treatment recommendation. In this study, we aimed to clarify major clinicopathological information, treatment strategies and prognosis of OBC based on a large population. Methods We retrospectively collected adult female OBC population from Surveillance, Epidemiology, and End Results (SEER) database. We divided the whole OBC cohort into two groups based on surgical treatment. Descriptive analysis of 18 clinicopathological variables was conducted by Wilcoxin rank sum test, Chi-square and Fisher’s exact test. Survival analysis was performed in the whole cohort as well as based on different clinicopathological factors. Univariate and multivariate Cox regression analysis was performed to identify potential independent predictor for prognosis of OBC. Results 1189 OBC patients was included in final analysis. Elderly patients predominated with a mean age of nearly 60. Most of the OBC patients were diagnosed as an early-stage carcinoma and ductal carcinoma took up nearly 40% of all the histological types of OBC. Luminal A is the commonest subtypes of OBC. For in-breast treatment, number of patients received mastectomy was 4 times more than that of patients received breast-conserving surgery (BCS). More than 70% patients receiving BCS took radiotherapy, significantly more than the portion of patients receiving radiation in mastectomy group (50.9%, P < 0.001). Median follow-up period of all subjects was about 62 months. 5-year and 10-year overall survival (OS) of the complete OBC cohort was 81.6% and 68.8%, respectively. No significant difference in OS and breast-cancer specific survival (BCSS) was found between mastectomy and BCS. Older age and larger number of positive lymph nodes causes a worse prognosis whereas radiotherapy brought a better clinical outcome for OBC patients. Conclusion OBC is a rare breast malignancy with a generally good prognosis. Less-intensive surgical intervention does not negatively impact clinical outcomes of OBC while additional radiotherapy is totally beneficial to prolong OS and BCSS.

scholarly journals SCUBE3 serves as an independent poor prognostic factor in breast cancer

2021 ◽  
Author(s):  
Qin Huo ◽  
Xi He ◽  
Zhenwei Li ◽  
Fan Yang ◽  
Shengnan He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Prognostic Factor ◽  
Poor Prognosis ◽  
Cox Regression ◽  
Functional Enrichment ◽  
High Expression ◽  
Poor Prognostic Factor ◽  
Cox Regression Analysis ◽  
Significant Difference

Abstract Background: Accumulating evidences indicate that the signal peptide-CUB-EGF-like domain-containing protein 3 (SCUBE3) plays a key role in the development and progression of many human cancers. However, the underlying mechanism and prognosis value of SCUBE3 in breast cancer are still unclear. Methods: The clinical data of 137 patients with breast cancer who underwent surgical resection in Taizhou Hospital of Zhejiang Province were retrospectively analyzed. We first conducted a comprehensive study on the expression pattern of SCUBE3 using the Tumor Immune Estimation Resource (TIMER) and UALCAN databases. In addition, the expression of SCUBE3 in breast tumor tissues was confirmed by immunohistochemistry. The protein-protein interaction analysis and functional enrichment analysis of SCUBE3 were analyzed using the STRING and Enrichr databases. Moreover, tissue microarray (TMA) was used to analyze the relationship between SCUBE3 expression levels and clinical-pathological parameters, such as histological type, grade, the status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). We further supplemented and identified the above results using the UALCAN and bc-GenExMiner v4.4 databases from TCGA data. The correlation between the expression of SCUBE3 and survival was calculated by multivariate Cox regression analysis to investigate whether SCUBE3 expression may be an independent prognostic factor of breast cancer. Results: We found that the expression level of SCUBE3 was significantly upregulated in breast cancer tissue compared with adjacent normal tissues. The results showed that the distribution of breast cancer patients in the high expression group and the low expression group was significantly different in ER, PR, HER2, E-cadherin, and survival state (p < 0.05), but there was no significant difference in age, histologic grade, histologic type, tumor size, lymph node metastasis, TMN stage, subtypes, or recurrence (p > 0.05). In addition, the high expression of SCUBE3 was associated with relatively poor prognosis of ER- (p = 0.012), PR- (p = 0.029), HER2+ (p = 0.007). The multivariate Cox regression analysis showed that the hazard ratio (HR) was 2.80 (95 % CI: 1.20-6.51, p = 0.0168) in individuals with high SCUBE3 expression, and HR was increased by 1.86 (95 % CI: 1.06-3.25, p = 0.0300) for per 1-point increase of SCUBE3 expression.Conclusions: These findings demonstrate that the high expression of SCUBE3 indicates poor prognosis in breast cancer. SCUBE3 expression may serve as a potential diagnostic indicator of breast cancer.

scholarly journals Significant Effect of Polymorphisms inCYP2D6andABCC2on Clinical Outcomes of Adjuvant Tamoxifen Therapy for Breast Cancer Patients

2010 ◽  
Vol 28 (8) ◽  
pp. 1287-1293 ◽  
Author(s):  
Kazuma Kiyotani ◽  
Taisei Mushiroda ◽  
Chiyo K. Imamura ◽  
Naoya Hosono ◽  
Tatsuhiko Tsunoda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Plasma Concentrations ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Tag Snps ◽  
Risk Alleles ◽  
Significant Difference ◽  
Variant Alleles

PurposeThe clinical efficacy of tamoxifen is suspected to be influenced by the activity of drug-metabolizing enzymes and transporters involved in the formation, metabolism, and elimination of its active forms. We investigated relationships of polymorphisms in transporter genes and CYP2D6 to clinical outcome of patients receiving tamoxifen.Patients and MethodsWe studied 282 patients with hormone receptor–positive, invasive breast cancer receiving tamoxifen monotherapy, including 67 patients who have been previously reported. We investigated the effects of allelic variants of CYP2D6 and haplotype-tagging single nucleotide polymorphisms (tag-SNPs) of ABCB1, ABCC2, and ABCG2 on recurrence-free survival using the Kaplan-Meier method and Cox regression analysis. Plasma concentrations of tamoxifen metabolites were measured in 98 patients receiving tamoxifen 20 mg/d.ResultsCYP2D6 variants were significantly associated with shorter recurrence-free survival (P = .000036; hazard ratio [HR] = 9.52; 95% CI, 2.79 to 32.45 in patients with two variant alleles v patients without variant alleles). Among 51 tag-SNPs in transporter genes, a significant association was found at rs3740065 in ABCC2 (P = .00017; HR = 10.64; 95% CI, 1.44 to 78.88 in patients with AA v GG genotypes). The number of risk alleles of CYP2D6 and ABCC2 showed cumulative effects on recurrence-free survival (P = .000000055). Patients carrying four risk alleles had 45.25-fold higher risk compared with patients with ≤ one risk allele. CYP2D6 variants were associated with lower plasma levels of endoxifen and 4-hydroxytamoxifen (P = .0000043 and .00052), whereas no significant difference was found among ABCC2 genotype groups.ConclusionOur results suggest that polymorphisms in CYP2D6 and ABCC2 are important predictors for the prognosis of patients with breast cancer treated with tamoxifen.

scholarly journals SCUBE3 serves as an independent poor prognostic factor in breast cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qin Huo ◽  
Xi He ◽  
Zhenwei Li ◽  
Fan Yang ◽  
Shengnan He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Prognostic Factor ◽  
Poor Prognosis ◽  
Cox Regression ◽  
Functional Enrichment ◽  
High Expression ◽  
Poor Prognostic Factor ◽  
Cox Regression Analysis ◽  
Significant Difference

Abstract Background Accumulating evidences indicate that the signal peptide-CUB-EGF-like domain-containing protein 3 (SCUBE3) plays a key role in the development and progression of many human cancers. However, the underlying mechanism and prognosis value of SCUBE3 in breast cancer are still unclear. Methods The clinical data of 137 patients with breast cancer who underwent surgical resection in Taizhou Hospital of Zhejiang Province were retrospectively analyzed. We first conducted a comprehensive study on the expression pattern of SCUBE3 using the Tumor Immune Estimation Resource (TIMER) and UALCAN databases. In addition, the expression of SCUBE3 in breast tumor tissues was confirmed by immunohistochemistry. The protein–protein interaction analysis and functional enrichment analysis of SCUBE3 were analyzed using the STRING and Enrichr databases. Moreover, tissue microarray (TMA) was used to analyze the relationship between SCUBE3 expression levels and clinical-pathological parameters, such as histological type, grade, the status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). We further supplemented and identified the above results using the UALCAN and bc-GenExMiner v4.4 databases from TCGA data. The correlation between the expression of SCUBE3 and survival was calculated by multivariate Cox regression analysis to investigate whether SCUBE3 expression may be an independent prognostic factor of breast cancer. Results We found that the expression level of SCUBE3 was significantly upregulated in breast cancer tissue compared with adjacent normal tissues. The results showed that the distribution of breast cancer patients in the high expression group and the low expression group was significantly different in ER, PR, HER2, E-cadherin, and survival state (p < 0.05), but there was no significant difference in histologic grade, histologic type, tumor size, lymph node metastasis, TMN stage, subtypes, or recurrence (p > 0.05). In addition, the high expression of SCUBE3 was associated with relatively poor prognosis of ER- (p = 0.012), PR- (p = 0.029), HER2 + (p = 0.007). The multivariate Cox regression analysis showed that the hazard ratio (HR) was 2.80 (95% CI 1.20–6.51, p = 0.0168) in individuals with high SCUBE3 expression, and HR was increased by 1.86 (95% CI 1.06–3.25, p = 0.0300) for per 1-point increase of SCUBE3 expression. Conclusions These findings demonstrate that the high expression of SCUBE3 indicates poor prognosis in breast cancer. SCUBE3 expression may serve as a potential diagnostic indicator of breast cancer.

Impact of omission of completion axillary lymph node dissection (cALND) or axillary radiotherapy (ax RT) in breast cancer patients with micrometastases (pN1mi) or isolated tumor cells (pN0[i+]) in the sentinel lymph node (SN): Results from the MIRROR study

2009 ◽  
Vol 27 (18_suppl) ◽  
pp. CRA506-CRA506 ◽  
Author(s):  
V. C. Tjan-Heijnen ◽  
M. J. Pepels ◽  
M. de Boer ◽  
G. F. Borm ◽  
J. A. van Dijck ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cox Regression ◽  
Research Question ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Tumor Characteristics ◽  
Number Of Patients ◽  
N Stage

CRA506 Background: The Dutch MIRROR study is the largest cohort study on pN1mi and pN0(i+) in the SN era with long-term follow-up, central pathology review (6th AJCC-classification), and separate analyses on the use of adjuvant systemic therapy (AST). In patients not receiving AST, pN1mi and pN0(i+) as final N-stage were shown to be independent prognosticators for disease-free survival (SABCS 2008, #23, oral). As a substantial number of patients in the MIRROR study did not undergo cALND or ax RT, we questioned whether this policy was safe in patients with pN1mi(sn) or pN0(i+)(sn). Methods: Patients operated for breast cancer in all Dutch hospitals in the years 1998–2005, having favorable primary tumor characteristics, and having undergone an SN biopsy without macrometastases as final N-stage were included. For this present research question, patients were categorized by their SN-stage. Median follow-up was 4.7 years. The Kaplan-Meier method was used to estimate 5-year axillary recurrence (AR) rates, and Cox regression was used to estimate the hazard ratios (HR). In the analyses, the effect of AST was taken into account. Results: In total, 835 patients with pN0(i-)(sn), 799 patients with pN0(i+)(sn), and 958 patients with pN1mi(sn) were included. AR rates, and HRs on AR are displayed below. Conclusions: Omission of cALND or ax RT in patients with pN1mi(sn) resulted in a significantly higher 5-year AR rate, even after correction for AST, and other patient and tumor characteristics. This indicates that patients with pN1mi(sn) should undergo cALND or ax RT to prevent AR. Support: The Netherlands Organization for Health Research and Development (ZonMw) and the Dutch Breast Cancer Trialists’ Group (BOOG). [Table: see text] No significant financial relationships to disclose.

Influence of hormone receptor status on survival in male breast cancer: A SEER database analysis.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 158-158 ◽  
Author(s):  
Orimisan Samuel Adekolujo ◽  
Shams Aziz Mistry ◽  
Nishkarsh Saxena ◽  
Marcello Schmidt ◽  
Perla Subbaiah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Breast Cancer ◽  
Hormone Receptors ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Male Breast ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Significant Difference

158 Background: In female breast cancer, estrogen receptor (ER) and/or progesterone receptor (PR) positivity confers a favorable prognosis; however, the effect of these hormone receptors (HR) on survival in male breast cancer (MBC) is controversial. The aim of this study isto determine if there is a difference in the 5 year cancer specific survival (CSS) rate of patients in different HR subgroups of MBC using the SEER database. Methods: We included patients with MBC ≥ 18 years of age in the SEER database from 1990 to 2011. Patients with unknown or borderline ER or PR status were excluded. Patients were divided into four subgroups based on HR status: ER+/PR+, ER+/PR-, ER-/PR+, ER-/PR-. Univariate analysis was done using t-test and chi-square. Multivariate Cox regression analysis was used to evaluate hazard ratios and determine the significance of covariates. Kaplan -Meier method was used to estimate survival. Results: We included 3,341 patients. The mean age was 64.9 years (SD 12.7) and most (2736, 81.9%) were Caucasians. The majority (2770, 82.9%) had ER+/PR+ tumors, 377 (11.3%) had ER+/PR- , 33 (1.0 %) had ER-/PR+ and 161(4.8%) had ER-/PR- tumors. Caucasians were more likely to have MBC positive for both ER and PR compared to African-Americans (84.1% versus 74.3%, P< 0.001). ER-/PR- tumors were more likely to be poorly differentiated compared to ER+/PR+ , ER+/PR- and ER-/PR+ (62.7%, 32.2%, 44.8%, 36.4% respectively , P<0.001). There was a significant difference in 5 year CSS of HR subgroups only in stage III and IV, with subgroups positive for ER consistently showing improved survival compared to ER-/PR- (Table). On multivariate analysis, positive ER or PR status was independently associated with decreased hazard of death (Hazard Ratio: 0.68 (p = 0.03); 0.78 (p = 0.04) respectively). Conclusions: Our study showed a significant difference in the 5 year CSS rate of patients in different HR subgroups of advanced stages (III and IV) of MBC. Positive HR status was associated with a better prognosis. [Table: see text]

scholarly journals Four Cycles of Docetaxel-Cyclophosphamide versus Anthracycline-Taxane as Adjuvant Chemotherapy for HER2-Negative, Axillary Lymph Node Negative Breast Cancer: A Real-World Comparison of Alberta Patients Treated 2008–2012

2021 ◽  
Vol 28 (2) ◽  
pp. 1137-1142
Author(s):  
Malek Hannouf ◽  
Atul Batra ◽  
Sasha Lupichuk
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Axillary Lymph Node ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Cancer Specific Survival ◽  
Node Negative ◽  
Significant Difference

Uncertainty exists around the need to include an anthracycline if taxane-based adjuvant chemotherapy is being used for human epidermal growth factor receptor-2 (HER2) negative and axillary lymph node negative (LNN) breast cancer. We identified all patients who were diagnosed with HER2-negative, LNN breast cancer treated with docetaxel-cyclophosphamide for four cycles (DC4) or an anthracycline-taxane (AT) regimen following surgical resection in Alberta from 2008 through 2012. We used propensity score methods to match each patient treated with AT to up to four patients treated with DC4 on potentially confounding clinicopathologic and treatment variables. We compared the 10-year invasive disease free survival (iDFS), breast cancer specific-survival (BCSS) and overall survival (OS) and assessed the effect of the type of adjuvant chemotherapy on these outcomes using Cox regression. Of the 726 eligible patients, 657 (90.5%) were treated with DC4 and 69 (9.5%) were treated with AT. Matching created a group of 202 women treated with DC4 and eliminated differences in clinicopathologic and treatment factors. There was no statistically significant difference for the treatment effects of matched DC4 patients compared to the AT patients on iDFS (75.7% vs. 76.8%, p = 0.75; hazard ratio (HR) = 1.05, 95% CI = 0.65 to 1.8), BCSS (88.1% vs. 87%, p = 0.8; HR = 0.91, 95% CI = 0.42 to 1.9), or OS (87.1% vs. 86.9%, p= 0.96; HR = 0.98, 95% CI = 0.46 to 2.1). Four cycles of DC as compared with an AT regimen yielded similar 10-year iDFS, BCSS and OS amongst patients with HER2-negative, LNN breast cancer.

scholarly journals Randomized Phase III Trial of Ixabepilone Plus Capecitabine Versus Capecitabine in Patients With Metastatic Breast Cancer Previously Treated With an Anthracycline and a Taxane

2010 ◽  
Vol 28 (20) ◽  
pp. 3256-3263 ◽  
Author(s):  
Joseph A. Sparano ◽  
Eduard Vrdoljak ◽  
Oliver Rixe ◽  
Binghe Xu ◽  
Alexey Manikhas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cox Regression ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Metastatic Breast ◽  
Phase Iii ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
Previously Treated

PurposeWe sought to determine whether the combination of ixabepilone plus capecitabine improved overall survival (OS) compared with capecitabine alone in patients with metastatic breast cancer (MBC) previously treated with anthracyclines and taxanes.Patients and MethodsA total of 1,221 patients with MBC previously treated with anthracycline and taxanes were randomly assigned to ixabepilone (40 mg/m2intravenously on day 1) plus capecitabine (2,000 mg/m2orally on days 1 through 14) or capecitabine alone (2,500 mg/m2on the same schedule) given every 21 days. The trial was powered to detect a 20% reduction in the hazard ratio (HR) for death.ResultsThere was no significant difference in OS between the combination and capecitabine monotherapy arm, the primary end point (median, 16.4 v 15.6 months; HR = 0.9; 95% CI, 078 to 1.03; P = .1162). The arms were well balanced with the exception of a higher prevalence of impaired performance status (Karnofsky performance status 70% to 80%) in the combination arm (32% v 25%). In a secondary Cox regression analysis adjusted for performance status and other prognostic factors, OS was improved for the combination (HR = 0.85; 95% CI, 0.75 to 0.98; P = .0231). In 79% of patients with measurable disease, the combination significantly improved progression-free survival (PFS; median, 6.2 v 4.2 months; HR = 0.79; P = .0005) and response rate (43% v 29%; P < .0001). Grade 3 to 4 neuropathy occurred in 24% treated with the combination, but was reversible.ConclusionThis study confirmed a previous trial demonstrating improved PFS and response for the ixabepilone-capecitabine combination compared with capecitabine alone, although this did not result in improved survival.

scholarly journals Dynamic Nomogram Predicts Overall Survival in Patients With Occult Breast Cancer: a Population-based Analysis

2021 ◽  
Author(s):  
Xiaomin Yang ◽  
Kunlong Li ◽  
Zhangjun Song ◽  
Huxia Wang ◽  
Sai He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Validation Cohort ◽  
Strategic Decision ◽  
Occult Breast Cancer ◽  
Training Cohort ◽  
Cox Regression Analysis ◽  
Ajcc Stage ◽  
Stage System

Abstract Background: Due the rarity of occult breast cancer (OBC), no precise prognostic instruments were available to assess the overall survival (OS) in patients with OBC. The aim of this study is to construct a nomogram for predicting the OS probability in patients with OBC. Methods: Patients who were enrolled in the Surveillance, Epidemiology, and End Results database between 2004 and 2015 were regarded as subjects and studied. We constructed a dynamic nomogram that can predict prognosis in patients with OBC based on crucial independent factors by using univariate and multivariate Cox regression analyses. C-index and calibration plots were chosen for validation. Net reclassification index (NRI), integrated discrimination improvement (IDI) and DCA (Ddecision Curve Analysis) were used to evaluate the nomogram’s clinical pragmatism. Results: Totally, 693 patients with OBC were included in this study. The nomogram integrated six independent prognostic factors through multivariate Cox regression analysis, such as surgical method, radiotherapy status, chemotherapy status, ER status, AJCC-stage and age. The prediction model exhibited robustness with the C-index 0.75 (95%CI: 0.72-0.77) in training cohort and 0.79 (95%CI: 0.76-0.82) in validation group. Moreover, the calibration curves presented favorably. The NRI values of 0.61 (95%CI: 0.28-0.99) for 5-year,0.53 (95%CI: 0.23-0.77) for 8-year OS prediction in the training cohort,0.75 (95%CI: 0.36-1.23) for 5-year and 0.6 (95%CI: 0.15-1.2) for 8-year OS prediction in the validation cohort,and the IDI values of 0.1 (95%CI: 0.04-0.17) for 5-year and 0.11 (95%CI: 0.03-0.19) for 8-year OS prediction in the training cohort, 0.21 (95%CI: 0.09-0.3) for 5-year and 0.22 (95%CI: 0.08-0.32) for 8-year OS prediction in the validation cohort,, indicated that the established nomogram performed significantly better than the AJCC stage system alone. Furthermore, DCA showed that the nomogram in our study was clinically useful and had better discriminative ability than the AJCC stage system. Conclusions: A nomogram was developed and validated to accurately predict the individualized probability OS for patients with occult breast cancer (OBC) and is expected to offer guidance for strategic decision.

Predictive Model for Live Birth at 12 Months After Starting In-Vitro Fertilization Treatment

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 5-20
Author(s):  
Vu Ho ◽  
Toan Pham ◽  
Tuong Ho ◽  
Lan Vuong
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Cox Regression ◽  
Financial Burden ◽  
Oocyte Retrieval ◽  
Operating Characteristics ◽  
Vitro Fertilization ◽  
Cox Regression Analysis ◽  
Significant Difference

IVF carries a considerable physical, emotional and financial burden. Therefore, it would be useful to be able to predict the likelihood of success for each couple. The aim of this retrospective cohort study was to develop a prediction model to estimate the probability of a live birth at 12 months after one completed IVF cycle (all fresh and frozen embryo transfers from the same oocyte retrieval). We analyzed data collected from 2600 women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) at a single center in Vietnam between April 2014 and December 2015. All patients received gonadotropin-releasing hormone (GnRH) antagonist stimulation, followed by fresh and/or frozen embryo transfer (FET) on Day 3. Using Cox regression analysis, five predictive factors were identified: female age, total dose of recombinant follicle stimulating hormone used, type of trigger, fresh or FET during the first transfer, and number of subsequent FET after the first transfer. The area under the receiver operating characteristics curve for the final model was 0.63 (95% confidence interval [CI] 0.60‒0.65) and 0.60 (95% CI 0.57‒0.63) for the validation cohort. There was no significant difference between the predicted and observed probabilities of live birth (Hosmer-Lemeshow test, p > 0.05). The model developed had similar discrimination to existing models and could be implemented in clinical practice.

scholarly journals Identification and development of an independent immune-related genes prognostic model for breast cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lin Chen ◽  
Yuxiang Dong ◽  
Yitong Pan ◽  
Yuhan Zhang ◽  
Ping Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Cox Regression ◽  
Gene Set Enrichment Analysis ◽  
Risk Scores ◽  
Validation Dataset ◽  
Immune Gene ◽  
Cox Regression Analysis ◽  
Immune Genes ◽  
Immune Related Genes

Abstract Background Breast cancer is one of the main malignant tumors that threaten the lives of women, which has received more and more clinical attention worldwide. There are increasing evidences showing that the immune micro-environment of breast cancer (BC) seriously affects the clinical outcome. This study aims to explore the role of tumor immune genes in the prognosis of BC patients and construct an immune-related genes prognostic index. Methods The list of 2498 immune genes was obtained from ImmPort database. In addition, gene expression data and clinical characteristics data of BC patients were also obtained from the TCGA database. The prognostic correlation of the differential genes was analyzed through Survival package. Cox regression analysis was performed to analyze the prognostic effect of immune genes. According to the regression coefficients of prognostic immune genes in regression analysis, an immune risk scores model was established. Gene set enrichment analysis (GSEA) was performed to probe the biological correlation of immune gene scores. P < 0.05 was considered to be statistically significant. Results In total, 556 immune genes were differentially expressed between normal tissues and BC tissues (p < 0. 05). According to the univariate cox regression analysis, a total of 66 immune genes were statistically significant for survival risk, of which 30 were associated with overall survival (P < 0.05). Finally, a 15 immune genes risk scores model was established. All patients were divided into high- and low-groups. KM survival analysis revealed that high immune risk scores represented worse survival (p < 0.001). ROC curve indicated that the immune genes risk scores model had a good reliability in predicting prognosis (5-year OS, AUC = 0.752). The established risk model showed splendid AUC value in the validation dataset (3-year over survival (OS) AUC = 0.685, 5-year OS AUC = 0.717, P = 0.00048). Moreover, the immune risk signature was proved to be an independent prognostic factor for BC patients. Finally, it was found that 15 immune genes and risk scores had significant clinical correlations, and were involved in a variety of carcinogenic pathways. Conclusion In conclusion, our study provides a new perspective for the expression of immune genes in BC. The constructed model has potential value for the prognostic prediction of BC patients and may provide some references for the clinical precision immunotherapy of patients.

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