Development and Validation of a Nomogram to Predict Chinese Breast Cancer Risk Based on Clinical Serum Biomarkers

Abstract

Background: This study investigated and compared clinical serum biomarkers and developed a diagnostic nomogram for breast cancer. Methods: A total of 1224 breast cancer and 1280 healthy controls were enrolled. Univariate and multivariate analyses were performed to identify factors and a nomogram was developed. Discrimination, accuracy and clinical utility values were evaluated by receiver operating characteristic, Hosmer–Lemeshow, calibration plots, decision curve analysis and clinical impact plots. Results: carcinoembryonic antigen, CA125, CA153, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, fibrinogen and platelet distributing width were effectively identified to predict breast cancer. The nomogram showed the area under the curve of 0.708 and 0.710 in the training and validation set. Calibration plots, Hosmer–Lemeshow, decision curve analysis and clinical impact plots confirmed great accuracy and clinical utility. Conclusion: We developed and validated a nomogram that is effectively used for risk prediction of Chinese breast cancer.

Keywords:

• breast cancer
• clinical laboratory indices
• inflammatory biomarkers
• nomogram
• risk model
• tumor biomarkers

Author contributions

Y Feng and N Li conceived and designed this study; N Li participated in the data arrangement; N Li, K Zhao and L Cao analyzed the data and interpreted the results; and N Li and L Cao drafted the manuscript. Y Feng and K Zhao revised the manuscript. All authors have read and agreed to the published version of the manuscript.

Financial & competing interests disclosure

This work was supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (grant no. 2019-I2M-5-027). The funders did not play any role in the design of the study, the decision to publish or the manuscript preparation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.