Henke Michael, Sindlinger Florian, Ikenberg Hans, Gerds Thomas, Schumacher Martin
Department of Radiotherapy, Radiological University Clinic, University Freiburg, Germany.
Strahlenther Onkol. 2004 Jan;180(1):45-51. doi: 10.1007/s00066-004-1123-7.
To determine whether the blood hemoglobin concentration correlates with the prognosis of patients with early breast cancer and, if so, whether this is restricted to treatment modality.
Data were collected retrospectively from patients with early breast cancer (T1,2 N0-2 M0) who underwent either breast-conserving surgery followed by adjuvant radiotherapy (BCS-RT; n=96) or a modified radical mastectomy (MRM; n=194). The effect of preoperative blood hemoglobin level, nodal status, histological grading and hormone receptor status on disease-free survival was determined for both treatment modalities using a Cox regression model and visualized by Kaplan-Meier plots.
The blood hemoglobin concentration significantly correlated with disease-free survival of patients receiving BCS-RT (relative risk [RR]: 0.67 per g/dl; p=0.007). This was independent of other known risk factors for breast cancer patients, as determined by multivariate analysis. By contrast, the blood hemoglobin level had no prognostic significance when patients were treated with MRM.
Blood hemoglobin concentration seems to affect the prognosis of patients with early breast cancer when a treatment schedule that includes radiotherapy is applied. Reduced radiosensitivity due to diminished tumor oxygenation may be the underlying cause. Confirmative trials and studies intended to elucidate the underlying mechanism are warranted.
确定血血红蛋白浓度是否与早期乳腺癌患者的预后相关，若相关，这种相关性是否仅限于治疗方式。
回顾性收集早期乳腺癌（T1,2 N0 - 2 M0）患者的数据，这些患者接受了保乳手术加辅助放疗（BCS - RT；n = 96）或改良根治性乳房切除术（MRM；n = 194）。使用Cox回归模型确定术前血血红蛋白水平、淋巴结状态、组织学分级和激素受体状态对两种治疗方式无病生存期的影响，并通过Kaplan - Meier曲线进行可视化展示。
血血红蛋白浓度与接受BCS - RT治疗患者的无病生存期显著相关（相对风险[RR]：每克/分升为0.67；p = 0.007）。多因素分析表明，这与乳腺癌患者的其他已知风险因素无关。相比之下，接受MRM治疗的患者，血血红蛋白水平无预后意义。
当应用包括放疗的治疗方案时，血血红蛋白浓度似乎会影响早期乳腺癌患者的预后。肿瘤氧合减少导致的放射敏感性降低可能是其潜在原因。有必要进行验证性试验和旨在阐明潜在机制的研究。
