预测年轻乳腺癌患者生存率列线图的建立和验证

目的:构建预测年轻乳腺癌患者生存情况的列线图，以期帮助临床诊疗。方法:收集SEER数据库中5 525例年轻乳腺癌患者的临床信息，通过单因素Log-rank检验和多因素Cox生存分析筛选出独立预后因素,用于构建预测患者3、5年总生存率(overall survival,OS)和癌症特异性生存率（cancer special survival,CSS)的列线图，将我院就诊的147例年轻乳腺癌患者作为验证集进行外部验证。结果:单因素和多因素分析结果显示，种族、病理类型、组织学分级、T分期、N分期、M分期、ER状态、HER-2状态、手术方式是与患者OS和CSS相关的独立危险因素，将这些因素纳入并建立预测患者OS和CSS的列线图模型。内部和外部验证结果显示模型具有良好的预测性能。基于建立的OS和CSS列线图模型对患者进行了风险分层，能够准确地将年轻乳腺癌患者分成预后有显著差异的三个风险亚组。结论:本研究构建的预测模型能较为准确的预测年轻乳腺癌患者的预后情况，为临床的诊疗提供科学依据。

Development and validation of nomogram for predicting survival outcomes in young breast cancer patients

Objective:To construct a nomogram to predict the survival of young patients with breast cancer in order to help clinical diagnosis and treatment.Methods:The clinical data of 5 525 young breast cancer patients in SEER database were collected.The independent prognostic factors were screened by univariate Log-rank test and multivariate Cox survival analysis and used to construct a line chart for predicting 3-and 5-year overall survival（OS) and cancer special survival（CSS).A total of 147 young breast cancer patients in our hospital were selected as a validation set for external validation.Results:The results of univariate and multivariate analysis showed that race,pathological type,histological grade,T stage,N stage,M stage,ER state,HER-2 state and mode of operation were independent risk factors associated with OS and CSS.These factors were included in the nomogram to predict OS and CSS.The internal and external verification results show that the model has good prediction performance.Risk stratification is carried out based on the established OS and CSS diagram model,which can accurately divide young breast cancer patients into three risk subgroups with significant differences in prognosis.Conclusion:The prediction model constructed in this study can accurately predict the prognosis of young patients with breast cancer and provide scientific basis for clinical diagnosis and treatment.