Development and validation of nomograms to predict survival in patients with invasive micropapillary carcinoma of the breast.

OBJECTIVES: The present study aimed to develop and validate nomograms to predict the survival of patients with breast invasive micropapillary carcinoma (IMPC) to aid objective decision-making. DESIGN: Prognostic factors were identified using Cox proportional hazards regression analyses and used to construct nomograms to predict overall survival (OS) and breast cancer-specific survival (BCSS) at 3 and 5 years. Kaplan-Meier analysis, calibration curves, the area under the curve (AUC) and the concordance index (C-index) evaluated the nomograms' performance. Decision curve analysis (DCA), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to compare the nomograms with the American Joint Committee on Cancer (AJCC) staging system. SETTING: Patient data were collected from the Surveillance, Epidemiology, and End Results (SEER) database. This database holds data related to the incidence of cancer acquired from 18 population-based cancer registries in the US. PARTICIPANTS: We ruled out 1893 patients and allowed the incorporation of 1340 patients into the present study. RESULTS: The C-index of the AJCC8 stage was lower than that of the OS nomogram (0.670 vs 0.766) and the OS nomograms had higher AUCs than the AJCC8 stage (3 years: 0.839 vs 0.735, 5 years: 0.787 vs 0.658). On calibration plots, the predicted and actual outcomes agreed well, and DCA revealed that the nomograms had better clinical utility compared with the conventional prognosis tool. In the training cohort, the NRI for OS was 0.227, and for BCSS was 0.182, while the IDI for OS was 0.070, and for BCSS was 0.078 (both p<0.001), confirming its accuracy. The Kaplan-Meier curves for nomogram-based risk stratification showed significant differences (p<0.001). CONCLUSIONS: The nomograms showed excellent discrimination and clinical utility to predict OS and BCSS at 3 and 5 years, and could identify high-risk patients, thus providing IMPC patients with personalised treatment strategies.

Construction and validation of a nomogram to predict overall survival in patients with breast sarcoma.

Background: This study aimed to construct a nomogram for Breast sarcoma (BS) to predict the prognosis of patients with BS accurately and provide a theoretical basis for individualized treatment. Methods: Patients selected from the Surveillance, Epidemiology and End Results (SEER) database from 2000 to 2018 were assigned to a training group (TG, n = 696) and an internal validation group (IVG, n = 299) at a 7:3 ratio. Cox regression analysis was performed on the TG, and statistically significant factors were used to establish a nomogram to predict 3-, 5-, and 10-year overall survival (OS). The nomogram's predictive power was validated using data from patients who attended our institution as the external validation group (EVG, n =79). Results: Cox regression analysis identified five factors, which were used to construct the nomogram. Good prediction accuracy was demonstrated using calibration curves. The concordance (C) indices for TG = 0.804 (95% confidence interval (CI) 0.777-0.831) and IVG = 0.761 (0.716-0.806) were higher than those based on 8th American Joint Committee on Cancer (AJCC8) stage: TG = 0.695 (0.660-0.730), IVG = 0.637 (0.584-0.690). The EVG also had a high C-index: 0.844 (0.768-0.920). Decision curve analysis showed that nomogram has larger net benefits than the AJCC8. The Kaplan-Meier curves of the nomogram-based risk groups showed significant differences (p < 0.001). Conclusions: The nomogram could accurately predict 3-, 5-, and 10-year OS and provided nomogram-based risk stratification, which could help physicians to personalize treatment plans for patients with BS.

A Serological Survey of Borrelia burgdorferi Infection in Sheep in Northeast China Regions Through Outer Surface Protein C-Based Enzyme-Linked Immunosorbent Assay.

Borrelia burgdorferi as a causative agent of Lyme disease is transmitted by Ixodes spp. ticks to humans and animals. Sheep is considered a natural reservoir for B. burgdorferi and plays a pivotal role in disease transmission and the expansion of natural foci. An epidemiological investigation of B. burgdorferi in sheep is essential for prevention and control of Lyme disease. In this study, we developed a recombinant outer surface protein C (OspC)-based ELISA for serological study of B. burgdorferi in sheep with a specificity and sensitivity of 84.4% and 86.2%, respectively. A total of 972 collected serum samples from the Northeast China regions in 2015 and 2016 were determined with positive rates of 5.8% and 12.2%, respectively. Thus, specific pathogen-free sheep were infected with B. burgdorferi SZ strain to study on the secretion of specificity antibody against OspC. It revealed that specific antibody was detected on day 5 postinoculation and sustained in a high level for ∼28 days, the peak occurred at ∼13 days. Taken together, the result indicated that the established ELISA is capable for clinical diagnosis and epidemiological study on B. burgdorferi in sheep at the early stage of infection and detecting the specific antibody during the secretion period.