生信做膩了嗎？或者不做生信資料探勘的，可以嘗試一下別的發文思路，例如挖掘SEER資料庫的臨床資料進行發表SCI。本次分享的範文發表在FRONT ONCOL上，影響因子：4.848，中科院分割槽：2區。
文章題目：Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study
研究背景：
Metastatic breast cancer (MBC) is a highly heterogeneous disease and bone is one of the most common metastatic sites. This retrospective study was conducted to investigate the clinical features, prognostic factors and benefits of surgery of breast cancer patients with initial bone metastases.
研究方法：
From 2010 to 2015, 6,860 breast cancer patients diagnosed with initial bone metastasis were analyzed from Surveillance, Epidemiology, and End Results (SEER) database. Univariate and Multivariable analysis were used to identify prognostic factors. A nomogram was performed based on the factors selected from cox regression result. Survival curves were plotted according to different subtypes, metastatic burdens and risk groups differentiated by nomogram.
研究結果：
Hormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) positive patients showed the best outcome compared to other subtypes. Patients of younger age (<60 years old), white race, lower grade, lower T stage (<=T2), not combining visceral metastasis tended to have better outcome. About 37% (2,249) patients received surgery of primary tumor. Patients of all subtypes could benefit from surgery. Patients of bone-only metastases (BOM), bone and liver metastases, bone and lung metastases also showed superior survival time if surgery was performed. However, patients of bone and brain metastasis could not benefit from surgery (p = 0.05). The C-index of nomogram was 0.66. Cutoff values of nomogram point were identified as 87 and 157 points, which divided all patients into low-, intermediate- and high-risk groups. Patients of all groups showed better overall survival when receiving surgery.
研究結論：
Our study has provided population-based prognostic analysis in patients with initial bone metastatic breast cancer and constructed a predicting nomogram with good accuracy. The finding of potential benefit of surgery to overall survival will cast some lights on the treatment tactics of this group of patients.
分析思路：
1、從SEER資料庫下載相關資料，然後整理好，進行卡方檢驗
2、進行單因素和多因素Cox迴歸分析
3、根據上面的結果，篩選出重要的臨床因素構建模型並繪製列線圖
4、計算C-index和繪製校準圖評價模型
5、根據風險評分和各臨床因素分組，分別繪製生存曲線，看預後價值
像這種發文思路，分析操作往往都是比較簡單的。比較難的地方就是需要對臨床專業意義比較熟悉，同時還要看結果的陽性程度，陽性程度越高，文章相對比較好發。如果想文章能發在更好的專業期刊上，就很可能需要收集額外的資料進行外部驗證。