Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Cancer Med. 2024 Jan;13(2):e6944. doi: 10.1002/cam4.6944.
Breast cancer (BC) is diagnosed as the most common cancer in women in 2022 according to the American Cancer Society. It is essential to detect early and treat early. Several studies have shown that some blood parameters have important predictive value for BC. In this study, we aim to explore whether some immune-associated blood parameters are relevant to disease-free survival (DFS) in early-stage BC.
A single-center, regression cohort study of 1490 patients with early-stage BC in Shanghai Cancer Center was conducted from January 2008 to December 2016. The patients were matched according to the ratio of 1:1 based on Propensity Score Matching (PSM). All patients who experienced disease progression were matched successfully. Thus, 58 pairs of subjects were obtained. Matched blood parameters were evaluated by paired samples t-test or Wilcoxon signed-rank test. Factors with statistical difference were further evaluated by stratified COX regression model.
Univariate analysis showed differences in platelet-related parameters (PLT, PCT, and PLR) and NLR between the two matched groups. However, stratified COX regression analysis, which ruled out the confounding effects of multiple factors, found that only PCT had prognostic value in early BC patients at baseline and study endpoint. Meanwhile, platelet-related parameters (PLT, MPV) and NLR were different in the progressive group by self before and after comparison. However, the multiple-factor analysis showed that only the NLR had prognostic value. ROC curve analysis indicated that the best sensitivity (65.45%) and specificity (78.18%) were obtained when the baseline PCT was 0.225. The optimal sensitivity (70.91%) and specificity (65.45%) were obtained when the PCT of disease progression was 0.215. The Kaplan-Meier curve was used to calculate the DFS rate based on the critical values of the two groups.
Some blood parameters have value to predict DFS in early-stage BC patients, especially platelet-associated parameters.
根据美国癌症协会的数据，乳腺癌（BC）是 2022 年女性中最常见的癌症。早期发现和早期治疗至关重要。多项研究表明，一些血液参数对 BC 具有重要的预测价值。在本研究中，我们旨在探讨早期 BC 患者的一些免疫相关血液参数与无病生存期（DFS）是否相关。
对 2008 年 1 月至 2016 年 12 月在上海肿瘤中心进行的单中心、回归队列研究的 1490 例早期 BC 患者进行了回顾性分析。根据倾向评分匹配（PSM），按 1:1 的比例对患者进行匹配。所有出现疾病进展的患者均成功匹配。因此，共获得 58 对受试者。配对样本 t 检验或 Wilcoxon 符号秩检验评估匹配的血液参数。通过分层 COX 回归模型进一步评估具有统计学差异的因素。
单因素分析显示，两组匹配患者的血小板相关参数（PLT、PCT 和 PLR）和 NLR 存在差异。然而，排除了多因素混杂效应的分层 COX 回归分析发现，只有 PCT 在基线和研究终点时对早期 BC 患者具有预后价值。同时，自身前后比较显示，进展组的血小板相关参数（PLT、MPV）和 NLR 不同。然而，多因素分析显示只有 NLR 具有预后价值。ROC 曲线分析表明，当基线 PCT 为 0.225 时，获得最佳的敏感性（65.45%）和特异性（78.18%）。当疾病进展时 PCT 为 0.215 时，获得最佳的敏感性（70.91%）和特异性（65.45%）。根据两组临界值，Kaplan-Meier 曲线计算 DFS 率。
一些血液参数对预测早期 BC 患者的 DFS 具有价值，尤其是血小板相关参数。
