Suppr超能文献

绝经后乳腺癌中骨转换升高预示着骨转移:NCIC CTG MA.14 的结果。

Elevated bone turnover predicts for bone metastasis in postmenopausal breast cancer: results of NCIC CTG MA.14.

机构信息

Penn State Hershey Cancer Institute, Division of Hematology/Oncology, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.

出版信息

J Clin Oncol. 2011 Sep 20;29(27):3605-10. doi: 10.1200/JCO.2010.31.5069. Epub 2011 Aug 22.

Abstract

PURPOSE

We investigated the association of bone-only relapse with a pretreatment marker of bone resorption: serum beta C-terminal telopeptide (B-CTx) of type I collagen.

METHODS

Pretreatment serum B-CTx concentrations were determined from 621 of 667 patients with primary breast cancer enrolled onto the NCIC CTG MA.14 phase III adjuvant trial of tamoxifen with or without octreotide. Recurrence-free survival (RFS) was a secondary end point; the focus here was bone-only relapse. We analyzed continuous or categorical (.71 ng/mL cut point) serum B-CTx in stepwise forward multivariate Cox regression, adjusted for trial stratification factors. We also examined B-CTx and bone relapse by pretrial chemotherapy status.

RESULTS

At median 7.9 years follow-up, 123 of 621 patients experienced recurrence; 19 (3.1%) of 621 had bone-only recurrence, and 47 (7.5%) of 621 had bone plus other sites of recurrence. Larger pathologic tumor size (P = .001) and elevated continuous and categorical serum B-CTx were associated with shorter bone-only RFS (both P = .02) when added to a model with factors significant in the main trial analyses (hazard ratio [HR], 3.43 and 3.50, respectively; 95% CI, 1.20 to 9.77 and 1.26 to 9.75, respectively). The univariate HR for B-CTx was 2.80 (95% CI, 1.05 to 7.48; P = .03). Elevated serum B-CTx was also associated with shorter bone-only RFS (P = .02) when added to a model with factors significant in the main trial analyses. Serum B-CTx level was not associated with any other type of recurrence. Serum B-CTx was not significantly different for patients who underwent pretrial chemotherapy, compared with those who did not (P = .27), nor did pretrial chemotherapy affect bone relapse (P = .48 for bone only; P = .76 for bone with other relapse).

CONCLUSION

Higher pretreatment serum B-CTx was a significant predictor of shorter RFS for bone-only metastasis. Increased bone resorption creates an environment that promotes growth of breast cancer cells.

摘要

目的

我们研究了与骨复发相关的一种骨吸收预处理标志物:I 型胶原β C 末端肽(B-CTX)。

方法

从纳入 NCIC CTG MA.14 期三苯氧胺辅助试验的 667 例原发性乳腺癌患者中的 621 例患者中测定了预处理血清 B-CTX 浓度。无病生存(DFS)是次要终点;这里的重点是骨复发。我们使用逐步向前多变量 Cox 回归分析了连续或分类(71ng/ml 切点)血清 B-CTX,调整了试验分层因素。我们还检查了术前化疗状态下的 B-CTX 和骨复发。

结果

中位随访 7.9 年后,621 例患者中有 123 例复发;621 例中有 19 例(3.1%)发生骨复发,621 例中有 47 例(7.5%)发生骨加其他部位复发。更大的病理肿瘤大小(P=0.001)和升高的连续和分类血清 B-CTX 与较短的骨复发 DFS 相关(均 P=0.02),当添加到主试验分析中有意义的因素模型中(风险比[HR]分别为 3.43 和 3.50;95%CI,分别为 1.20 至 9.77 和 1.26 至 9.75)。B-CTX 的单变量 HR 为 2.80(95%CI,1.05 至 7.48;P=0.03)。升高的血清 B-CTX 与较短的骨复发 DFS 相关(P=0.02),当添加到主试验分析中有意义的因素模型中时。血清 B-CTX 水平与任何其他类型的复发无关。与未接受术前化疗的患者相比,接受术前化疗的患者的血清 B-CTX 水平无显著差异(P=0.27),术前化疗也不影响骨复发(骨复发时 P=0.48;骨复发加其他部位复发时 P=0.76)。

结论

较高的预处理血清 B-CTX 是骨转移无病生存较短的显著预测因子。骨吸收增加会产生促进乳腺癌细胞生长的环境。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验