Qu Fanli, Chen Rui, Peng Yang, Ye Ying, Tang Zhenrong, Wang Yihua, Zong Beige, Yu Haochen, Liu Shengchun
Department of Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Breast Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, China.
J Breast Cancer. 2020 Jun;23(3):246-258. doi: 10.4048/jbc.2020.23.e32.
Effective predictors of the response to neoadjuvant chemotherapy (NAC) are still insufficient. This study aimed to investigate the predictive value of serum lipid profiles for the response to NAC in breast cancer patients.
A total of 533 breast cancer patients who had received NAC were retrospectively studied. The pretreatment of serum lipids, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein-α, and clinicopathological characteristics were collected to assess their predictive roles.
Breast cancer patients had significantly lower TC, TG, HDL-C, and LDL-C levels than normal individuals. Among these indicators, TG and LDL-C levels and HDL-C level increased and decreased significantly after NAC, respectively. In estrogen receptor (ER)-positive patients, increased LDL-C level was associated with better outcomes. Moreover, the receiver operating characteristic curve analyses suggested that TG and HDL-C levels at diagnosis can be used as predictors of the response to NAC only in the ER-positive subgroup. According to univariate analyses, patients with low TG level (< 1.155 mmol/L) or high HDL-C level (≥ 1.305 mmol/L) in the ER-positive subgroup had more favorable clinical responses than the other patients in the subgroup. Furthermore, according to multivariate analyses, a high HDL-C level (≥ 1.305 mmol/L, = 0.007) was an independent predictor of NAC efficacy.
High HDL-C level (≥ 1.305 mmol/L) before NAC and increased LDL-C level after NAC were associated with the better treatment response in ER-positive breast cancer patients. These results are potentially considered beneficial in establishing treatment decisions.
新辅助化疗(NAC)疗效的有效预测指标仍然不足。本研究旨在探讨血清脂质谱对乳腺癌患者NAC疗效的预测价值。
回顾性研究了533例接受NAC的乳腺癌患者。收集治疗前血清脂质水平,包括总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和脂蛋白α,以及临床病理特征,以评估它们的预测作用。
乳腺癌患者的TC、TG、HDL-C和LDL-C水平显著低于正常个体。在这些指标中,NAC后TG和LDL-C水平显著升高,HDL-C水平显著降低。在雌激素受体(ER)阳性患者中,LDL-C水平升高与较好的预后相关。此外,受试者工作特征曲线分析表明,仅在ER阳性亚组中,诊断时的TG和HDL-C水平可作为NAC疗效的预测指标。单因素分析显示,ER阳性亚组中TG水平低(<1.155 mmol/L)或HDL-C水平高(≥1.305 mmol/L)的患者比该亚组中的其他患者具有更良好的临床反应。此外,多因素分析显示,高HDL-C水平(≥1.305 mmol/L,P = 0.007)是NAC疗效的独立预测指标。
NAC前HDL-C水平高(≥1.305 mmol/L)和NAC后LDL-C水平升高与ER阳性乳腺癌患者更好的治疗反应相关。这些结果可能有助于制定治疗决策。