Ruszkowska-Ciastek Barbara, Bielawski Kornel, Zarychta Elżbieta, Rhone Piotr
Department of Pathophysiology, Faculty of Pharmacy, Nicolaus Copernicus University, Collegium Medicum, 85-094 Bydgoszcz, Poland.
Clinical Ward of Breast Cancer and Reconstructive Surgery, Oncology Centre Prof. F. Łukaszczyk Memorial Hospital, 85-796 Bydgoszcz, Poland.
J Clin Med. 2021 May 18;10(10):2184. doi: 10.3390/jcm10102184.
In recent years, great progress has been made in the treatment of breast cancer, but it is still one of the ten leading causes of death in women. The aim of the study was to evaluate the heparanase concentration of invasive breast cancer (IBrC) patients, before and after cancer adjuvant treatment.
Eighty patients with stage IA to IIB IBrC receiving adjuvant treatment were included prospectively in this study. The heparanase concentrations were determined by an enzyme-linked immunosorbent assay. A univariate analysis was used to estimate the factors influencing the low or high pre-treatment concentration of heparanase and the low or high numerical decrease in heparanase concentration after completion of adjuvant treatment.
Treatment reduced the concentration of heparanase by almost four times in the general IBrC cohort. Higher levels of pre- and post-treatment heparanase were noted in oestrogen receptor-negative cancers than in positive ones. A higher post-treatment concentration of heparanase was found in patients with a triple-negative tumour compared to patients with a luminal B HER2 negative type of IBrC. Overweight IBrC subjects and those with a tumour diameter of ≥2 cm demonstrated a lower chance of a lower pre-treatment heparanase concentration. Interestingly, a pre-treatment heparanase concentration is the main predictor of the changes in heparanase concentration after adjuvant treatment. Follow-up revealed significantly lower progression-free survival (PFS) rates in IBrC patients with a pre-treatment concentration of heparanase higher than 181.46 pg/mL (PFS = 80%).
Our findings provide supporting evidence that IBrC therapy reduced the heparanase levels, regardless of treatment patterns and a pre-treatment concentration of heparanase may serve as a prognostic indicator for future outcomes.
近年来，乳腺癌治疗取得了巨大进展，但它仍是女性十大主要死因之一。本研究的目的是评估浸润性乳腺癌（IBrC）患者在癌症辅助治疗前后的乙酰肝素酶浓度。
本研究前瞻性纳入了80例接受辅助治疗的IA至IIB期IBrC患者。通过酶联免疫吸附测定法测定乙酰肝素酶浓度。采用单因素分析来评估影响乙酰肝素酶治疗前浓度高低以及辅助治疗完成后乙酰肝素酶浓度数值下降高低的因素。
在一般IBrC队列中，治疗使乙酰肝素酶浓度降低了近四倍。雌激素受体阴性癌症患者治疗前和治疗后的乙酰肝素酶水平高于阳性患者。与管腔B型HER2阴性的IBrC患者相比，三阴性肿瘤患者治疗后的乙酰肝素酶浓度更高。超重的IBrC受试者和肿瘤直径≥2 cm的受试者治疗前乙酰肝素酶浓度较低的可能性较小。有趣的是，治疗前乙酰肝素酶浓度是辅助治疗后乙酰肝素酶浓度变化的主要预测指标。随访显示，治疗前乙酰肝素酶浓度高于181.46 pg/mL的IBrC患者无进展生存期（PFS）率显著较低（PFS = 80%）。
我们的研究结果提供了支持性证据，即IBrC治疗降低了乙酰肝素酶水平，无论治疗模式如何，治疗前乙酰肝素酶浓度可作为未来预后的指标。
