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辅助化疗期间乳腺癌女性患者炎症状态及全身抗氧化-氧化平衡的评估

The evaluation of the inflammatory status and systemic antioxidant-oxidant balance of women with breast cancer during adjuvant chemotherapy.

作者信息

Grupińska Joanna, Budzyń Magdalena, Janowski Jakub, Gryszczyńska Bogna, Kaja Elżbieta, Brzeziński Jacek J, Leporowska Ewa, Formanowicz Dorota, Kycler Witold

机构信息

Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Poznan, Poland.

Hospital Pharmacy, Greater Poland Cancer Centre, Poznan, Poland.

出版信息

Rep Pract Oncol Radiother. 2024 Oct 3;29(4):488-500. doi: 10.5603/rpor.102130. eCollection 2024.

Abstract

BACKGROUND

Chemotherapy may cause systemic inflammation. Therefore, reliable markers monitoring inflammation during cancer treatment are intensively investigated. In our study, we analyzed the concentration of high-sensitivity C-reactive protein (hs-CRP) and selected oxidative stress markers, such as malondialdehyde (MDA), glutathione peroxidase activity (GPx), and total antioxidant capacity (TAC), in breast cancer women before and during adjuvant chemotherapy.

MATERIALS AND METHODS

The study included 90 women with breast cancer stratified according to clinicopathological and anthropometric features. Blood samples were taken before and after two cycles of adjuvant chemotherapy.

RESULTS

During adjuvant chemotherapy, a significant increase in hs-CRP concentration was noticed in the entire group of patients with breast cancer. After division into appropriate groups, a twofold increase in hs-CRP concentration was particularly observed in patients not expressing steroid hormone receptors and those without metastases in regional lymph nodes. A significant rise in hs-CRP was observed in patients with smaller tumor sizes (2 cm ≤) and with a lower stage of disease [I-IIA according to the tumor-node-metastasis (TNM) classification]. Adjuvant chemotherapy resulted in a significant decrease in GPx activity, especially in patients diagnosed with larger (> 2 cm) and more advanced tumors (IIB-IIIC according to the TNM classification), without metastasis in regional lymph nodes, and without HER-2 expression. A significant decrease in glutathione peroxidase (GPx) activity during adjuvant chemotherapy was also observed in patients with abnormal body mass index (BMI) and body fat content. TAC and MDA values remained unchanged in the entire group of patients and individual subgroups during adjuvant chemotherapy.

CONCLUSION

Our study showed that adjuvant chemotherapy causes systemic inflammation, manifested by increased hs-CRP and altered markers of oxidative stress in the blood of breast cancer patients. The severity of inflammatory processes during adjuvant chemotherapy may depend on specific characteristics of breast cancer and body composition.

摘要

背景

化疗可能会引发全身炎症。因此,人们正在深入研究用于监测癌症治疗期间炎症的可靠标志物。在我们的研究中,我们分析了辅助化疗前后乳腺癌女性患者体内高敏C反应蛋白(hs-CRP)的浓度以及选定的氧化应激标志物,如丙二醛(MDA)、谷胱甘肽过氧化物酶活性(GPx)和总抗氧化能力(TAC)。

材料与方法

该研究纳入了90名根据临床病理和人体测量特征分层的乳腺癌女性患者。在辅助化疗的两个周期前后采集血样。

结果

在辅助化疗期间,整个乳腺癌患者组的hs-CRP浓度显著升高。在分为适当的组后,尤其在不表达类固醇激素受体且区域淋巴结无转移的患者中观察到hs-CRP浓度增加了两倍。在肿瘤较小(2 cm≤)且疾病分期较低[根据肿瘤-淋巴结-转移(TNM)分类为I-IIA期]的患者中观察到hs-CRP显著升高。辅助化疗导致GPx活性显著降低,尤其是在诊断为肿瘤较大(>2 cm)且病情更晚期(根据TNM分类为IIB-IIIC期)、区域淋巴结无转移且无HER-2表达的患者中。在体重指数(BMI)和体脂含量异常的患者中,辅助化疗期间也观察到谷胱甘肽过氧化物酶(GPx)活性显著降低。在辅助化疗期间,整个患者组和各个亚组的TAC和MDA值均保持不变。

结论

我们的研究表明,辅助化疗会引发全身炎症,表现为乳腺癌患者血液中hs-CRP升高和氧化应激标志物改变。辅助化疗期间炎症过程的严重程度可能取决于乳腺癌的特定特征和身体组成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/570f/11785379/6627e907b288/rpor-29-4-488f1.jpg

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