白蛋白与纤维蛋白原比值与乳腺癌患者总生存期的关系

Relation Between Albumin to Fibrinogen Ratio and Overall Survival of Breast Cancer

目的探讨白蛋白与纤维蛋白原比值(albumin to fibrinogen ratio,AFR)与乳腺浸润性导管癌患者总生存期的关系。方法收集2009年1月—2012年4月河北医科大学第四医院乳腺中心收治的230例乳腺浸润性导管癌患者血液及临床资料,回顾性分析患者术前临床资料,计算AFR,Kaplan-Meier法及Cox比例回归风险模型进行生存分析,采用二分类方式,分为AFR<13.1与AFR≥13.1两组,采用单因素及多因素分析其与患者的生存关系,并建立预后模型。结果AFR≥13.1时患者生存率降低,AFR是改善总生存期(OS)的独立预后因素,将多因素分析里P<0.05的变量,即将AFR、白细胞(WBC)、雌激素受体(ER)孕激素受体(PR)、TNM分期、核分级、p53及脉管瘤栓7个指标建立OS预测模型,其受试者工作特征曲线(ROC)面积为0.882。结论AFR低表达是改善乳腺癌OS的独立预后因素,AFR、WBC、ER或PR、TNM、核分级、p53及脉管瘤栓7个指标建立OS预测模型,具有很好预测乳腺浸润性导管癌患者生存率的作用。

Objective To investigate the prognostic significance of albumin to fibrinogen ratio(AFR)in breast infiltrating ductal carcinoma.Methods We collected 230 blood and clinical data of breast invasive ductal carcinoma admitted to the Breast Center of the Fourth Hospital of Hebei Medical University from January 2009 to April 2012.A retrospective study was conducted to collect fibrinogen and albumin indicators from preoperative patients.Survival analysis was performed using Kaplan-Meier method and Cox proportional regression risk model to explore the relation between AFR expression and prognosis.AFR was divided into two groups by two classifications:AFR<13.1 and AFR≥13.1.The univariate and multivariate analyses were used to analysis the relation between AFR and patients’survival,then a prognosis model was established.Results The survival rate of patients was reduced when AFR≥13.1.In the multivariate analysis,the variables with P<0.05 were used to create a model.AFR,white blood cell(WBC),estrogen receptor(ER)or progesterone receptor(PR),TNM,nuclear grading,p53,vascular tumor thrombus and other OS indicators were used to predict the survival time of patients.The receiver operating characteristic(ROC)curve area was 0.882.Conclusion Low AFR expression is an independent prognostic factor for breast cancer.Seven indicators,including AFR,WBC,ER/PR,TNM,nuclear grading,p53 and vascular tumor thrombus,were used to create an OS predictive model,which could predict the prognosis of breast infiltrating ductal carcinoma patients.