Bel'skaya Lyudmila V, Sarf Elena A
Biochemistry Research Laboratory, Omsk State Pedagogical University, 14 Tukhachevsky str, 644043 Omsk, Russia.
Metabolites. 2022 Jun 16;12(6):552. doi: 10.3390/metabo12060552.
Despite the fact that breast cancer was detected in the early stages, the prognosis was not always favorable. In this paper, we examined the impact of clinical and pathological characteristics of patients and the composition of saliva before treatment on overall survival and the risk of recurrence of primary resectable breast cancer. The study included 355 patients of the Omsk Clinical Oncology Center with a diagnosis of primary resectable breast cancer (TNM). Saliva was analyzed for 42 biochemical indicators before the start of treatment. We have identified two biochemical indicators of saliva that can act as prognostic markers: alkaline phosphatase (ALP) and diene conjugates (DC). Favorable prognostic factors were ALP activity above 71.7 U/L and DC level above 3.93 c.u. Additional accounting for aspartate aminotransferase (AST) activity allows for forming a group with a favorable prognosis, for which the relative risk is reduced by more than 11 times (HR = 11.49, 95% CI 1.43-88.99, = 0.01591). Salivary AST activity has no independent prognostic value. Multivariate analysis showed that tumor size, lymph nodes metastasis status, malignancy grade, tumor HER2 status, and salivary ALP activity were independent predictors. It was shown that the risk of recurrence decreased with menopause and increased with an increase in the size of the primary tumor and lymph node involvement. Significant risk factors for recurrence were salivary ALP activity below 71.7 U/L and DC levels below 3.93 c.u. before treatment. Thus, the assessment of biochemical indicators of saliva before treatment can provide prognostic information comparable in importance to the clinicopathological characteristics of the tumor and can be used to identify a risk group for recurrence in primary resectable breast cancer.
尽管乳腺癌在早期被检测到，但其预后并不总是良好。在本文中，我们研究了患者的临床和病理特征以及治疗前唾液成分对原发性可切除乳腺癌的总生存期和复发风险的影响。该研究纳入了355名鄂木斯克临床肿瘤中心诊断为原发性可切除乳腺癌（TNM）的患者。在治疗开始前对唾液进行了42种生化指标的分析。我们确定了两种可作为预后标志物的唾液生化指标：碱性磷酸酶（ALP）和二烯共轭物（DC）。预后良好的因素是ALP活性高于71.7 U/L和DC水平高于3.93 c.u.。额外考虑天冬氨酸转氨酶（AST）活性可形成一个预后良好的组，其相对风险降低超过11倍（HR = 11.49，95% CI 1.43 - 88.99， = 0.01591）。唾液AST活性没有独立的预后价值。多变量分析表明，肿瘤大小、淋巴结转移状态、恶性程度分级、肿瘤HER2状态和唾液ALP活性是独立的预测因素。结果表明，复发风险随着绝经而降低，随着原发肿瘤大小和淋巴结受累程度的增加而增加。治疗前唾液ALP活性低于71.7 U/L和DC水平低于3.93 c.u.是复发的重要危险因素。因此，治疗前唾液生化指标的评估可以提供与肿瘤临床病理特征同等重要的预后信息，并可用于识别原发性可切除乳腺癌的复发风险组。
