用贝叶斯方法评价影响乳腺癌患者生存的因素

Mahan Bahmanziari, A. Saki Malehi, M. Raesizadeh, M. Seghatoleslami, M. Hoseinzade, E. Maraghi
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引用次数: 0

摘要

背景与目的:乳腺癌是女性癌症死亡的最重要原因。本研究采用贝叶斯方法建立参数比例风险模型,探讨雌激素受体(ER)、人表皮生长受体(HER2)等因素对乳腺癌患者术后生存的影响。材料与方法:本研究为回顾性研究。将2004 - 2014年在Ahvaz愈合诊断中心接受手术的165例乳腺癌患者的数据记录在数据收集表中。评估年龄、肿瘤大小、受累淋巴结数、肿瘤分级、ER状态和HER2状态等变量。生存时间从手术日期到死亡日期或研究结束日期(2015年9月),以月为单位计算。在贝叶斯方法中,在具有比例风险的参数生存分析模型中,使用MCMC方法估计参数的横向分布。同时,利用偏差信息准则对模型的有效性进行了评价。所有数据分析步骤均采用Stata15软件进行。模型的显著性系数采用95%可信区间确定。结果:年龄均值46.40岁,标准差9.94岁。威布尔参数模型的偏差信息准则低于其他参数模型。基于威布尔比例风险参数模型的贝叶斯估计,肿瘤大小(HR = 1.40)、累及淋巴结数量(HR = 1.016)、Ki67状态(HR = 1.115)、肿瘤分级(HR = 1.022)、HER2状态(HR = 1.760)和ER状态(HR = 1.381)对死亡风险有正向影响。年龄对死亡风险有负相关影响(HR=0.978)。结论:基于贝叶斯比例风险威布尔模型,肿瘤大小、累及淋巴结数、Ki67、肿瘤分级、HER2、ER与死亡风险呈正相关。
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Evaluation of the Influential Factors Affecting Survival of the Patients with Breast Cancer Using Bayesian Method
Background and Aim: Breast cancer is the most important cause of cancer death in women. The purpose of this study was to evaluate the effect of Estrogen Receptor (ER), Human Epidermal Growth Receptor (HER2) and other factors on post-surgical survival of the patients with breast cancer using Bayesian approach for parametric proportional hazards model. Materials and Methods: This was a retrospective study. Data of 165 breast cancer patients who had undergone surgery at Ahvaz Healing Diagnostic Center from 2004 to 2014 were recorded in a data collection form. The variables of age, tumor size, number of lymph nodes involved, cancer grade, ER status and HER2 status were evaluated. Survival time was calculated from the date of surgery to the date of death or study end date (September 2015), in months. In the Bayesian approach in parametric survival analysis models with proportional hazards, the lateral distribution of parameters was estimated using MCMC method. Also, we evaluated efficiency of the models using the deviance information criterion. All data analysis steps were performed by using Stata15 software. Significance coefficients of the model were determined using the 95% credible interval. Results: The mean and standard deviation of age were 46.40 and 9.94 years, respectively. Deviance information criterion for Weibull parametric model was lower than those of other parametric models. Based on the Bayesian estimation of the Weibull's proportional hazards parametric model, tumor size (HR = 1.40), the number of involved lymph nodes (HR = 1.016), Ki67 status (HR = 1.115), tumor grade (HR = 1.022), HER2 status (HR = 1.760) and ER status (HR = 1.381) had a positive effect on risk of death. Age had a negative effect on risk of death (HR=0.978). Conclusion: Based on the Bayesian proportional hazards Weibull model, tumor size, the number of involved lymph nodes, Ki67, tumor's grade, HER2 and ER had a positive effect on the risk of death.
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4 weeks
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