Liu YongCheng, Wu Di, Wang HuiJuan, Zheng HeMing
Department of Surgical Oncology, Zhejiang University Medical School Affiliated Sir Run Run Shaw Hospital, Hangzhou, China.
Cancer Control. 2024 Jan-Dec;31:10732748241311225. doi: 10.1177/10732748241311225.
Although dyslipidemia has been shown to be associated with breast cancer prognosis, the prognostic value of high-density lipoprotein (HDL) in triple-negative breast cancer (TNBC) remains uncertain. The purpose of this study was to evaluate the relationship between preoperative HDL levels and prognosis in TNBC patients.
Preoperative HDL levels and clinical data from 287 patients who underwent TNBC surgery were retrospectively collected. Overall survival (OS) and disease-free survival (DFS) were analyzed via the Kaplan-Meier method and the Cox proportional hazards regression model.
Via the combination of receiver operating characteristics and Kaplan-Meier analysis, we found that low HDL levels were a prognostic factor for TNBC. Patients with lower HDL levels had a significantly lower T1 ratio than patients with higher HDL levels and exhibited a significantly higher neoadjuvant chemotherapy ratio than patients with higher HDL levels. In univariate analysis, the DFS and OS of patients with low HDL levels were worse than those of patients with high HDL levels in terms of DFS (HR: 0.452; 95% CI: 0.237-0.862; = 0.016) and OS (HR: 0.438; 95% CI: 0.199-0.968; = 0.041). However, in the multivariate analysis, there was no difference observed between patients with low HDL levels and those with high HDL levels in terms of DFS or OS. According to the subgroup analysis, lymph node-negative (N-) patients with low levels of HDL had worse DFS and OS than did patients with high HDL levels. However, in lymph node-positive (N+) patients, there was no difference observed in prognosis between the high- and low-HDL groups.
Low HDL levels are correlated with the progression of TNBC. Moreover, low HDL levels (particularly in patients who are N-) have been identified as a significant prognostic factor impacting the prognosis of TNBC patients; however, these levels do not represent an independent prognostic factor.
尽管血脂异常已被证明与乳腺癌预后相关，但高密度脂蛋白（HDL）在三阴性乳腺癌（TNBC）中的预后价值仍不确定。本研究的目的是评估TNBC患者术前HDL水平与预后之间的关系。
回顾性收集287例行TNBC手术患者的术前HDL水平和临床资料。通过Kaplan-Meier法和Cox比例风险回归模型分析总生存期（OS）和无病生存期（DFS）。
通过结合受试者工作特征曲线和Kaplan-Meier分析，我们发现低HDL水平是TNBC的一个预后因素。HDL水平较低的患者的T1比例显著低于HDL水平较高的患者，且新辅助化疗比例显著高于HDL水平较高的患者。在单因素分析中，HDL水平低的患者在DFS（HR：0.452；95%CI：0.237-0.862；P=0.016）和OS（HR：0.438；95%CI：0.199-0.968；P=0.041）方面比HDL水平高的患者差。然而，在多因素分析中，HDL水平低的患者与HDL水平高的患者在DFS或OS方面没有差异。根据亚组分析，HDL水平低的淋巴结阴性（N-）患者的DFS和OS比HDL水平高的患者差。然而，在淋巴结阳性（N+）患者中，HDL水平高和低的组之间在预后方面没有差异。
低HDL水平与TNBC的进展相关。此外，低HDL水平（特别是在N-患者中）已被确定为影响TNBC患者预后的一个重要预后因素；然而，这些水平并不代表一个独立的预后因素。
