淋巴结比率在病理T1/2期乳腺癌患者中的潜在预后价值及其与循环性激素浓度的相关性：一项回顾性研究

Potential prognostic value of the lymph node ratio and its correlation with circulating sex hormone concentration in pathological T1/2 breast cancer patients: a retrospective study.

作者信息

Zhu Wangyu, Qiu Xia, Lin Nawa, Fang Kexin, Zhang Tinglei, Ishii Naohiro, Rozen Warren Matthew, Hamidian Jahromi Alireza, Huang Jian

机构信息

Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Cell and Molecular Biology Laboratory, Zhoushan Hospital, Zhoushan, China.

出版信息

Ann Transl Med. 2022 May;10(10):585. doi: 10.21037/atm-22-2039.

DOI:10.21037/atm-22-2039

PMID:35722397

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9201154/

Abstract

BACKGROUND

The lymph node ratio (LNR) is an additional informative factor complementing anatomic TNM staging in breast cancer patients. The aim of this study was to evaluate the role of LNR in the cancer-specific and overall survival (OS) in a cohort of pT1/2 breast cancer patients and examine its correlation with circulating sex hormone concentrations in postmenopausal cases of the cohort from eastern China islands.

METHODS

Clinical and pathological characteristics, preoperational sex hormone and tumor markers concentrations, and breast cancer-specific survival (BCSS) and OS were analyzed retrospectively in 732 pathological T1/2 breast cancer patients.

RESULTS

The LNR was calculated, and the cut-off value was defined as 0.042 by receiver operative characteristic (ROC) curve according to the patient's mortalities. Patients with LNR ≥0.042 exhibited worse BCSS and OS than others (P<0.001) in pT1/2 breast cancer. Among patients with non-triple negative breast cancer (TNBC) and TNBC subtypes, the LNR ≥0.042 group also exhibited worse BCSS and OS than the LNR <0.042 group (P=0.003, 0.001, and P=0.032, 0.001, respectively). In univariate analysis, unfavorable BCSS and OS were both related with LNR ≥0.042 (P=0.001, <0.001). However multivariate analysis demonstrated TNBC subtypes were independent predictor for BCSS and OS [hazard ratio (HR) =1.449, 95% CI: 1.097-1.914, P=0.009; HR =1.365, 95% CI: 1.093-1.705, P=0.006, respectively]. Notably, Pearson or spearman correlation analysis revealed follicle-stimulating hormone (FSH) and, luteinizing hormone (LH) levels were significantly negatively associated with the LNR (P=0.007, 0.011, respectively) in postmenopausal cases, whereas CA153, CA125 and CEA were positively correlated with it (P<0.001, <0.001, 0.001, respectively) in all cases.

CONCLUSIONS

Among pT1/2 breast cancer patients from eastern China islands, the LNR is a predictive prognosis factor; a higher LNR seems to correlate with a worse survival outcome both overall and in the subgroups. Strikingly, the current results reveal that serum FSH and LH level inversely associated with axillary node invasion in postmenopausal cases, whereas tumor markers directly related with it. The LNR is an informative factor complementing TNM staging.

摘要

背景

淋巴结比率（LNR）是补充乳腺癌患者解剖学TNM分期的一个额外信息因素。本研究的目的是评估LNR在中国东部岛屿队列中pT1/2乳腺癌患者的癌症特异性生存和总生存（OS）中的作用，并研究其与绝经后病例循环性激素浓度的相关性。

方法

回顾性分析732例病理T1/2乳腺癌患者的临床和病理特征、术前性激素和肿瘤标志物浓度以及乳腺癌特异性生存（BCSS）和OS。

结果

计算LNR，并根据患者死亡率通过受试者工作特征（ROC）曲线将临界值定义为0.042。在pT1/2乳腺癌中，LNR≥0.042的患者表现出比其他患者更差的BCSS和OS（P<0.001）。在非三阴性乳腺癌（TNBC）及其亚型患者中，LNR≥0.042组的BCSS和OS也比LNR<0.042组更差（分别为P=0.003、0.001和P=0.032、0.001）。单因素分析中，不良的BCSS和OS均与LNR≥0.042相关（P=0.001，<0.001）。然而，多因素分析表明TNBC亚型是BCSS和OS的独立预测因素[风险比（HR）=1.449，95%置信区间：1.097-1.914，P=0.009；HR =1.365，95%置信区间：1.093-1.705，P=0.006]。值得注意的是，Pearson或Spearman相关性分析显示，在绝经后病例中，促卵泡生成素（FSH）和促黄体生成素（LH）水平与LNR显著负相关（分别为P=0.007、0.011），而在所有病例中，CA153、CA125和CEA与LNR呈正相关（分别为P<0.001、<0.001、0.001）。