Yoo Young-Chul, Park Seho, Kim Hyun-Joo, Jung Hyun-Eom, Kim Ji-Young, Kim Myoung-Hwa
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
Devision of Breast Cancer, Department of General Surgery, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
J Clin Med. 2021 Jun 13;10(12):2610. doi: 10.3390/jcm10122610.
Simple, convenient, and reliable preoperative prognostic indicators are needed to estimate the future risk of recurrences and guide the treatment decisions associated with breast cancer. We evaluated preoperative hematological markers related to recurrence and mortality and investigated independent risk factors for recurrence and mortality in patients after breast cancer surgery. We reviewed electronic medical records of patients with invasive breast cancer diagnosed at our tertiary institution between November 2005 and December 2010 and followed them until 2015. We compared two groups of patients classified according to recurrence or death and identified risk factors for postoperative outcomes. Data from 1783 patients were analyzed ultimately. Cancer antigen (CA) 15-3 and red cell distribution width (RDW) had the highest area under the curve values among several preoperative hematological markers for disease-free survival and overall survival (0.590 and 0.637, respectively). Patients with both preoperative CA 15-3 levels over 11.4 and RDW over 13.5 had a 1.7-fold higher risk of recurrence (hazard ratio (HR): 1.655; 95% confidence interval (CI): 1.154-2.374; = 0.007) and mortality (HR: 1.723; 95% CI: 1.098-2.704; = 0.019). In conclusion, relatively high preoperative RDW (>13.5) and CA 15-3 levels (>11.4) had the highest predictive power for mortality and recurrence, respectively. When RDW and CA 15-3 exceeded the cut-off value, the risk of recurrence and death also increased approximately 1.7 times.
需要简单、便捷且可靠的术前预后指标来评估乳腺癌复发的未来风险，并指导相关治疗决策。我们评估了与复发和死亡率相关的术前血液学标志物，并调查了乳腺癌手术后患者复发和死亡的独立危险因素。我们回顾了2005年11月至2010年12月在我们三级医疗机构诊断为浸润性乳腺癌患者的电子病历，并随访至2015年。我们比较了根据复发或死亡分类的两组患者，并确定了术后结果的危险因素。最终分析了1783例患者的数据。在几个术前血液学标志物中，癌抗原（CA）15-3和红细胞分布宽度（RDW）在无病生存期和总生存期方面的曲线下面积值最高（分别为0.590和0.637）。术前CA 15-3水平超过11.4且RDW超过13.5的患者复发风险高1.7倍（风险比（HR）：1.655；95%置信区间（CI）：1.154-2.374；P = 0.007），死亡风险高1.723倍（HR：1.723；95%CI：1.098-2.704；P = 0.019）。总之，术前相对较高的RDW（>13.5）和CA 15-3水平（>11.4）分别对死亡率和复发具有最高的预测能力。当RDW和CA 15-3超过临界值时，复发和死亡风险也增加约1.7倍。
