Construction of a prediction model for the recurrence risk of breast cancer patients undergoing radiotherapy after breast-conserving surgery based on cadherin expression profiles and tumor pathological features

Zhu Xianglu; Li Shan; Zhang Chenguang; Mu Kedais Baiktiyar; Wang Yihai

doi:10.3969/j.issn.1671-6450.2026.02.014

Abstract：Objective To construct a risk prediction model for recurrence in breast cancer patients after breast-con-serving surgery and radiotherapy based on the cadherin expression profile and tumor pathological features,and to evaluate the efficacy of this model.Methods A total of 298 breast cancer patients who underwent breast-conserving surgery at the Affili-ated Cancer Hospital of Xinjiang Medical University from February 2020 to February 2023 were selected as the research sub-jects.Based on whether recurrence occurred within 2 years after breast-conserving surgery combined with radiotherapy,the pa-tients were divided into a recurrence group(19 cases)and a non-recurrence group(279 cases).Immunohistochemistry(IHC)was used to detect the expressions of E-cadherin,N-cadherin,P-cadherin,and VE-cadherin.Multivariate logistic regression analysis was performed to identify influencing factors related to recurrence in breast cancer patients after breast-conserving surgery and radiotherapy,and a nomogram prediction model was constructed.Receiver operating characteristic(ROC)curve analysis was used to evaluate the value of the model in predicting recurrence after breast-conserving surgery and radiotherapy in breast cancer patients.Results Compared with the non-recurrence group,the recurrence group had a larger maximum tumor diameter,higher proportions of poorly differentiated tumors,TNM stage Ⅱ tumors,and HER-2 positivity,as well as a higher Ki-67 index,while the proportions of ER positivity and PR positivity were lower(t/x2/P=2.385/0.018,6.569/0.037,4.566/0.033,4.689/0.030,3.837/0.049,4.502/0.034,2.453/0.015).Additionally,the recurrence group had a longer operation time,a higher proportion of systemic radiotherapy-related adverse reactions,and a lower proportion of patients who received boost irradiation to the tumor bed compared with the non-recurrence group(t/x2/P=2.092/0.037,4.264/0.039,4.264/0.039).The proportions of low E-cadherin expression,high N-cadherin expression,and high VE-cadherin expression in the recurrence group were higher than those in the non-recurrence group(x2/P=7.968/0.005,6.866/0.009,6.170/0.013).Multivariate logistic regression analysis showed that larger maximum tumor diameter,poorly differentiated tumor,higher Ki-67 index,high N-cad-herin expression,and high VE-cadherin expression were independent risk factors for recurrence in breast cancer patients after breast-conserving surgery and radiotherapy[OR(95％CI)=16.846(2.653-106.984),4.276(1.459-12.536),1.342(1.082-1.664),4.034(1.038-15.675),4.217(1.070-16.624)],while receiving boost irradiation to the tumor bed and high E-cadherin expression were independent protective factors[OR(95％CI)=0.154(0.036-0.666),0.130(0.027-0.624)].ROC curve anal-ysis showed that the area under the curve(AUC)of the model for predicting recurrence after breast-conserving surgery and ra-diotherapy in breast cancer patients was 0.905(95％CI=0.850-0.961),with a sensitivity of 0.886 and a specificity of 0.900.Conclusion Maximum tumor diameter,tumor differentiation degree(poor differentiation),Ki-67 index,receipt of boost irra-diation to the tumor bed,and expressions of E-cadherin,N-cadherin,and VE-cadherin in breast cancer patients are all associat-ed with recurrence after breast-conserving surgery and radiotherapy.The model constructed based on the aforementioned tumor pathological features and cadherin expression profile can effectively predict the recurrence risk of breast cancer patients after breast-conserving surgery and radiotherapy.