Yu Sheng, Zhao Jingjing, Wang Menglian, Cheng Guo, Li Wen, Tang Lingxue, Yao Senbang, Pang Lulian, Yin Xiangxiang, Jing Yanyan, Cheng Huaidong
Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Finance, University of Connecticut, Storrs, CT, United States.
Front Med (Lausanne). 2022 Aug 25;9:945433. doi: 10.3389/fmed.2022.945433. eCollection 2022.
Early detection and intervention are of great significance to the clinical management of cancer-related diseases. Peripheral blood biomarkers [e.g., neutrophil-to-lymphocyte ratio (NLR), carcinoembryonic antigen (CEA), and carbohydrate antigen 153 (CA153)] are obtained in real-timely, conveniently, and less invasively, and proved to availably predicted the disease states and prognosis of various cancers, including breast cancer (BC). Inflammation and poor disease management promote cognitive impairment. Chemotherapy-related cognitive impairment (CRCI) hazard long-term survival and quality of life (QOL) of BC patients, but its correlation with NLR, CEA, and CA153 is not clear.
This study aimed to investigate changes in NLR, CEA, and CA153 levels before and after chemotherapy and their correlation with CRCI in patients with early-stage BC.
The 187 patients with BC who were measured for NLR, CEA, and CA153 values within the first 24 hours of admission, were assigned into two groups: the before/after chemotherapy group (BCG/ACG). The ACG was assigned into two subgroups based on the cognitive assessment results: the cognitive normal/impaired group (CNG/CIG). Patients' self-perceived cognitive impairments were evaluated using a mini-mental state examination (MMSE), prospective and retrospective memory (PM and RM) questionnaire (PRMQ), and functional assessment of cancer therapy-cognitive function version 3 (FACT-Cog, version 3, including CogPCI, CogOth, CogPCA, and CogQOL). Their QOL was also evaluated.
The NLR and CA153 levels were elevated after chemotherapy (BCG vs ACG: = -1.996 and -1.615, = 0.046 and 0.106, respectively), and significantly elevated in patients with CRCI (BCG vs CIG: = -2.444 and -2.293, = 0.015 and 0.022; respectively). However, there was not reach significant difference in CEA levels between the four groups. In addition, there was a weak to moderate correlation between peripheral blood biomarkers (NLR, CEA, and CA153) levels and CRCI ( = -0.404, -0.205, -0.322; respectively; < 0.001). Cognitive impairment scores (MMSE, PM, RM, and FACT-Cog) had a strong correlation with QOL in patients with early-stage BC ( = -0.786, 0.851, 0.849, and 0.938; respectively; < 0.001).
NLR and CA153 m be valuable diagnostic adjuncts of CRCI, and CRCI has a strong correlation with QOL in patients with early-stage BC.
早期发现和干预对癌症相关疾病的临床管理具有重要意义。外周血生物标志物[如中性粒细胞与淋巴细胞比值（NLR）、癌胚抗原（CEA）和糖类抗原153（CA153）]获取实时、便捷且侵入性小，并被证明可有效预测包括乳腺癌（BC）在内的各种癌症的疾病状态和预后。炎症和疾病管理不善会导致认知障碍。化疗相关认知障碍（CRCI）危害BC患者的长期生存和生活质量（QOL），但其与NLR、CEA和CA153的相关性尚不清楚。
本研究旨在探讨早期BC患者化疗前后NLR、CEA和CA153水平的变化及其与CRCI的相关性。
187例在入院后24小时内测量了NLR、CEA和CA153值的BC患者被分为两组：化疗前后组（BCG/ACG）。ACG根据认知评估结果分为两个亚组：认知正常/受损组（CNG/CIG）。使用简易精神状态检查表（MMSE）、前瞻性和回顾性记忆（PM和RM）问卷（PRMQ）以及癌症治疗认知功能第3版功能评估（FACT-Cog，第3版，包括CogPCI、CogOth、CogPCA和CogQOL）评估患者自我感知的认知障碍。还评估了他们的QOL。
化疗后NLR和CA153水平升高（BCG与ACG比较：分别为=-1.996和-1.615，=0.046和0.106），CRCI患者中显著升高（BCG与CIG比较：分别为=-2.444和-2.293，=0.015和0.022）。然而，四组之间CEA水平无显著差异。此外，外周血生物标志物（NLR、CEA和CA153）水平与CRCI之间存在弱至中度相关性（分别为=-0.404、-0.205、-0.322；<0.001）。早期BC患者的认知障碍评分（MMSE、PM、RM和FACT-Cog）与QOL密切相关（分别为=-0.786、0.851、0.849和0.938；<0.001）。
NLR和CA153可能是CRCI的有价值诊断辅助指标，且CRCI与早期BC患者的QOL密切相关。
