Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Breast Cancer Center, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan.
Breast Cancer. 2022 Jan;29(1):156-163. doi: 10.1007/s12282-021-01292-3. Epub 2021 Sep 6.
Several studies have recently reported that the relationships between serum vitamin D and the prognosis or the pathological response to neoadjuvant chemotherapy (NAC) in breast cancer. However, there are no data regarding the clinical impacts of the vitamin D in Japanese breast cancer patients so far.
In the present study, a total of 250 patients with clinical Stage I-III primary breast cancer who were treated with NAC and subsequently underwent definitive surgery were included. Serum 25-hydroxvitamin D (25(OH)D) levels were evaluated using blood samples obtained before NAC.
The serum 25(OH)D was positively associated with age, and the serum 25(OH)D was significantly higher in postmenopausal women than that in pre/peri-menopausal women. Serum 25(OH)D level was not associated with the achievement of pathological complete response (pCR) in this cohort. The low 25(OH)D levels were significantly associated with shorter time to distant recurrence (TTDR). According to the univariate analysis, high clinical stage before NAC (cStage III) and low serum 25(OH)D level were significantly associated with the shorter TTDR, and pCR was significantly associated with the longer TTDR. According to a multivariate analysis, low serum 25(OH)D level were independent poor prognostic factors for TTDR.
The low 25(OH)D levels were significantly associated with poorer prognosis in Japanese women with operable breast cancer patients treated with NAC.
最近有几项研究报告称，血清维生素 D 与乳腺癌的预后或新辅助化疗（NAC）的病理反应之间存在关系。然而，目前尚无关于日本乳腺癌患者维生素 D 的临床影响的数据。
本研究共纳入 250 例接受 NAC 治疗后行确定性手术的临床 I-III 期原发性乳腺癌患者。在 NAC 前采集血样评估血清 25-羟维生素 D（25（OH）D）水平。
血清 25（OH）D 与年龄呈正相关，绝经后妇女的血清 25（OH）D 明显高于绝经前/围绝经期妇女。在该队列中，血清 25（OH）D 水平与病理完全缓解（pCR）的获得无关。低 25（OH）D 水平与远处复发时间（TTDR）缩短显著相关。根据单因素分析，NAC 前高临床分期（cStage III）和低血清 25（OH）D 水平与 TTDR 缩短显著相关，pCR 与 TTDR 延长显著相关。多因素分析显示，低血清 25（OH）D 水平是 TTDR 的独立不良预后因素。
低血清 25（OH）D 水平与接受 NAC 治疗的可手术乳腺癌日本女性患者的预后较差显著相关。
