Reclassified the phenotypes of cancer types and construct a nomogram for predicting bone metastasis risk: A pan-cancer analysis

作者全名："Li, Ming; Yu, Wenqian; Zhang, Chao; Li, Huiyang; Li, Xiuchuan; Song, Fengju; Li, Shiyi; Jiang, Guoheng; Li, Hongyu; Mao, Min; Wang, Xin"

作者地址："[Li, Ming] Southwest Jiaotong Univ, Peoples Hosp Chengdu 3, Sect HepatoPancreatoBiliary Surg, Dept Gen Surg,Affiliated Hosp, Chengdu, Peoples R China; [Li, Ming] Chongqing Med Univ, Affiliated Hosp 2, Chengdu, Peoples R China; [Yu, Wenqian; Li, Shiyi; Jiang, Guoheng; Li, Hongyu; Wang, Xin] Sichuan Univ, West China Publ Hlth Sch, Dept Epidemiol & Hlth Stat, Chengdu, Peoples R China; [Yu, Wenqian; Li, Shiyi; Jiang, Guoheng; Li, Hongyu; Wang, Xin] Sichuan Univ, West China Hosp 4, Chengdu, Peoples R China; [Zhang, Chao] Tianjin Med Univ Canc Inst & Hosp, Dept Bone & Soft Tissue Tumours, Key Lab Canc Prevent & Therapy, Natl Clin Res Ctr Canc,Tianjins Clin Res Ctr Canc, Tianjin, Peoples R China; [Li, Huiyang; Li, Xiuchuan] Gen Hosp Western Theater Command, Dept Cardiol, Chengdu, Peoples R China; [Song, Fengju] Tianjin Med Univ Canc Inst & Hosp, Dept Epidemiol & Biostat, Key Lab Canc Prevent & Therapy, Tianjin Key Lab Breast Canc Prevent & Therapy,Mini, Tianjin, Peoples R China; [Mao, Min] Sichuan Univ, West China Univ Hosp 2, Joint Lab Lung Dev & Related Dis, Chengdu, Peoples R China; [Mao, Min] Sichuan Univ, Fudan Univ, West China Univ Hosp 2, Sch Life Sci,West China Inst Women Childrens Hlth, Chengdu, Peoples R China; [Wang, Xin] Sichuan Univ, West China Sch Publ Hlth, Dept Epidemiol & Biostat, South Renmin Rd, Chengdu 610041, Peoples R China; [Wang, Xin] Sichuan Univ, West China Hosp 4, South Renmin Rd, Chengdu 610041, Peoples R China"

通信作者："Mao, M (通讯作者)，Sichuan Univ, West China Univ Hosp 2, Joint Lab Lung Dev & Related Dis, Chengdu, Peoples R China.; Mao, M (通讯作者)，Sichuan Univ, Fudan Univ, West China Univ Hosp 2, Sch Life Sci,West China Inst Women Childrens Hlth, Chengdu, Peoples R China.; Wang, X (通讯作者)，Sichuan Univ, West China Sch Publ Hlth, Dept Epidemiol & Biostat, South Renmin Rd, Chengdu 610041, Peoples R China.; Wang, X (通讯作者)，Sichuan Univ, West China Hosp 4, South Renmin Rd, Chengdu 610041, Peoples R China."

来源：CANCER MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001176393000001

JCR分区：Q2

影响因子：2.9

年份：2024

卷号：13

期号：3

开始页：　

结束页：　

文献类型：Article

关键词：associated factors; bone metastasis; cancer classification system; prediction nomogram

摘要："Background: Numerous of models have been developed to predict the bone metastasis (BM) risk; however, due to the variety of cancer types, it is difficult for clinicians to use these models efficiently. We aimed to perform the pan-cancer analysis to create the cancer classification system for BM, and construct the nomogram for predicting the BM risk. Methods: Cancer patients diagnosed between 2010 and 2018 in the Surveillance, Epidemiology, and End Results (SEER) database were included. Unsupervised hierarchical clustering analysis was performed to create the BM prevalence-based cancer classification system (BM-CCS). Multivariable logistic regression was applied to investigate the possible associated factors for BM and construct a nomogram for BM risk prediction. The patients diagnosed between 2017 and 2018 were selected for validating the performance of the BM-CCS and the nomogram, respectively. Results: A total of 50 cancer types with 2,438,680 patients were included in the construction model. Unsupervised hierarchical clustering analysis classified the 50 cancer types into three main phenotypes, namely, categories A, B, and C. The pooled BM prevalence in category A (17.7%; 95% CI: 17.5%-17.8%) was significantly higher than that in category B (5.0%; 95% CI: 4.5%-5.6%), and category C (1.2%; 95% CI: 1.1%-1.4%) (p < 0.001). Advanced age, male gender, race, poorly differentiated grade, higher T, N stage, and brain, lung, liver metastasis were significantly associated with BM risk, but the results were not consistent across all cancers. Based on these factors and BM-CCS, we constructed a nomogram for predicting the BM risk. The nomogram showed good calibration and discrimination ability (AUC in validation cohort = 88%,95% CI: 87.4%-88.5%; AUC in construction cohort = 86.9%,95% CI: 86.8%-87.1%). The decision curve analysis also demonstrated the clinical usefulness. Conclusion: The classification system and prediction nomogram may guide the cancer management and individualized BM screening, thus allocating the medical resources to cancer patients. Moreover, it may also have important implications for studying the etiology of BM."

基金机构：The Foundation of Science and Technology of Sichuan Province

基金资助正文："This work was supported by the Natural Science Foundation of China (81903398, 81702161, 81801781, 81802508, 8191101553), the Natural Science Foundation of Tianjin Science and Technology Committee China (17JCQNJC11000), Chongqing Natural Science Foundation Program (cstc2019jcyjmsxmX0466), the Fundamental Research Funds for the Central Universities (YJ2021112), ""From 0 to 1"" innovation project of Sichuan University (2023SCUH0026), Sichuan Provincial Science and Technology Department central guide local science and technology development special project (2023ZYD0097), Sichuan Outstanding Youth Science Fund Project (2023NSFC1927), Sichuan Medical Association Youth Innovation Project (Q2016), 2023 Sichuan University graduate education teaching reform project (GSSCU2023043), The Foundation of Science and Technology of Sichuan Province (2021YFS0101).r No Statement Availabler No Statement Availabler No Statement Availabler No Statement Availabler No Statement Availabler No Statement Availabler No Statement Availabler No Statement Availabler No Statement Available"