血浆纤维蛋白原水平与乳腺癌新辅助化疗疗效及预后的相关性

Correlation between plasma fibrinogen level and the efficacy and prognosis of neoadjuvant chemotherapy for breast cancer

目的:评估血浆纤维蛋白原水平与乳腺癌新辅助化疗患者临床效果和预后的关系。方法:使用Clauss凝固法定量检测188例乳腺癌患者新辅助化疗前外周血中纤维蛋白原水平,根据纤维蛋白原水平将患者分为降低组、正常组或升高组。分析纤维蛋白原水平与病理完全缓解(pCR)的相关性,并进行预后分析。结果:月经状态与血浆纤维蛋白原水平相关(P<0.05)。纤维蛋白原水平是pCR的独立预测因素(P=0.002,95%CI:1.699~9.347)。Kaplan-Meier分析显示血浆纤维蛋白原水平升高组的无病生存期(DFS)和总生存期(OS)缩短(P<0.05)。单因素和多因素生存分析均显示分子分型、肿瘤大小、淋巴结状态、纤维蛋白原水平及pCR是DFS和OS的独立预后因素(P<0.05)。结论:血浆纤维蛋白原水平降低提示预后较好,血浆纤维蛋白原水平可能成为预测局部晚期乳腺癌患者新辅助化疗pCR和预后的生物学标志物。

Objective:To investigate the relationship between the plasma fibrinogen level and the clinical progression and prognosis of breast cancer patients receiving neoadjuvant chemotherapy.Methods:Plasma fibrinogen concentrations of peripheral venous blood samples in 188 breast cancer patients receiving neoadjuvant chemotherapy was detected by clotting method of Clauss.The association between the plasma fibrinogen level and pCR and prognosis were analyzed.Results:Plasma fibrinogen level was significantly correlated with menopause(P<0.05).Multivariate logistic regression analysis showed that plasma fibrinogen level was an independent predictor of pCR(P<0.05).Kaplan-Meier analysis showed that patients with increased fibrinogen level after neoadjuvant chemotherapy had significantly shorter disease-free survival and overall survival(P<0.05).In univariate and multivariate survival analysis,subtypes,pCR,tumor size,lymph node status and changes in plasma fibrinogen level were all associated with disease-free survival and overall survival(P<0.05).Conclusion:Breast cancer patients with decreased fibrinogen level had high pCR rate and better prognosis.Plasma fibrinogen level may be a possible marker for pCR and prognosis of patients with breast cancer receiving neoadjuvant chemotherapy.