Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, Houston, TX, 77030, USA.
Morgan Welch Inflammatory Breast Cancer Research Program, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, Houston, TX, 77030, USA.
Breast Cancer Res Treat. 2017 Dec;166(3):819-832. doi: 10.1007/s10549-017-4463-6. Epub 2017 Aug 22.
Platelets are essential components of hemostasis and also play an important role in the tumor microenvironment. The purposes of our research were to examine the role of thrombocytosis in inflammatory breast cancer (IBC) and to know which cytokine drives thrombocytosis.
We reviewed the medical records of 3654 patients with stage I-III breast cancer treated between 1998 and 2013, including 230 patients (6%) with IBC. We used Chi-squared test or Fisher's exact test to compare the variables between patients with and without thrombocytosis. Multivariate Cox regression models were used to determine the association of thrombocytosis with overall survival. We also examined baseline serum cytokine levels in 81 patients with primary IBC to determine the association of inflammatory cytokines with thrombocytosis.
We found that thrombocytosis was the only variable that predicted prognosis. Fifty-five patients (1.5%) had thrombocytosis. Thrombocytosis was more prevalent in patients with IBC than in those with non-IBC (3.4% vs. 1.4%, p = 0.015). In patients with IBC, thrombocytosis was associated with worse overall survival [hazard ratio 2.38, 95% confidence interval (CI) 1.05-5.4, p = 0.0378]. Circulating levels of growth-regulated oncogene (GRO) (odds ratio 1.003, 95% CI 1.001-1.005, p = 0.0019) and transforming growth factor β (TGF-β) (odds ratio 1.3, 95% CI 1.128-1.499, p = 0.0003) were associated with thrombocytosis.
Thrombocytosis was more prevalent in patients with IBC than in those with non-IBC and it was associated with poor prognosis. GRO and TGF-β were associated with thrombocytosis in IBC.
血小板是止血的重要组成部分，在肿瘤微环境中也发挥着重要作用。我们研究的目的是研究血小板增多症在炎性乳腺癌（IBC）中的作用，并了解哪种细胞因子驱动血小板增多症。
我们回顾了 1998 年至 2013 年间接受治疗的 3654 例 I 期至 III 期乳腺癌患者的病历，其中包括 230 例（6%）IBC 患者。我们使用卡方检验或 Fisher 确切检验比较血小板增多症患者和无血小板增多症患者之间的变量。多变量 Cox 回归模型用于确定血小板增多症与总生存的关联。我们还检查了 81 例原发性 IBC 患者的基线血清细胞因子水平，以确定炎症细胞因子与血小板增多症的关系。
我们发现血小板增多症是唯一预测预后的变量。55 例（1.5%）患者血小板增多症。IBC 患者的血小板增多症发生率高于非 IBC 患者（3.4%对 1.4%，p=0.015）。在 IBC 患者中，血小板增多症与总生存预后较差相关[风险比 2.38，95%置信区间（CI）1.05-5.4，p=0.0378]。循环生长调节癌基因（GRO）水平（比值比 1.003，95%CI 1.001-1.005，p=0.0019）和转化生长因子β（TGF-β）（比值比 1.3，95%CI 1.128-1.499，p=0.0003）与血小板增多症相关。
IBC 患者中血小板增多症的发生率高于非 IBC 患者，与预后不良相关。GRO 和 TGF-β与 IBC 中的血小板增多症相关。
