乳腺癌患者新辅助化疗前后血浆FIB、DD水平和CD4^(+)、CD4^(+)/CD8^(+)变化与预后的相关性分析

Correlation analysis of plasma FIB,DD levels,CD4^(+)、CD4^(+)/CD8^(+)changes and prognosis in patients with breast cancer before and after neoadjuvant chemotherapy

目的:探讨乳腺癌(BC)患者新辅助化疗(NAC)前后血浆纤维蛋白原(FIB)、D-二聚体(DD)水平、CD4^(+)和CD4^(+)/CD8^(+)变化与预后的相关性。方法:选取140例行NAC的BC患者为研究对象,根据预后分为无进展组(n=113)和进展组(n=27)。比较两组患者NAC前后血浆FIB、DD及细胞免疫功能指标水平;Kaplan-Meier绘制两年总生存率(OS)及无进展生存期(PFS)曲线;Cox分析影响预后的因素。结果:进展组NAC前后血浆FIB、DD和CD3^(+)、CD4^(+)、CD8^(+)水平高于无进展组(P<0.05),CD4^(+)/CD8^(+)低于无进展组(P<0.05);血浆FIB、DD和CD4^(+)/CD8^(+)低水平患者中位OS和中位DFS均高于高水平患者(P<0.05);Cox分析显示,分子分型和FIB、DD、CD4^(+)/CD8^(+)是BC患者NAC预后的影响因素。结论:BC患者NAC后血浆FIB、DD和CD4^(+)水平升高,CD4^(+)/CD8^(+)水平降低,且与患者预后密切相关。

Objective:To explore the correlation between plasma fibrinogen(FIB),D-Dimer(DD)levels,CD4^(+),CD4^(+)/CD8^(+)changes and prognosis in patients with breast cancer(BC)before and after neoadjuvant chemotherapy(NAC).Methods:140 BC patients with NAC were selected as the study objects.According to different prognosis,they were divided into non-progression group(n=113)and progression group(n=27).The levels of plasma FIB,DD and cellular immune function indexes before and after NAC in the two groups were compared.The curves of 2-year overall survival(OS)and progression-free survival(PFS)were drawn by Kaplan-Meier method.The influencing factors of prognosis were analyzed by Cox analysis.Results:Before and after NAC,levels of plasma FIB,DD,CD3^(+),CD4^(+)and CD8^(+)in progression group were higher than those in non-progression group,while CD4^(+)/CD8^(+)was lower than that in non-progression group(P<0.05).The median OS and DFS in low levels of FIB,DD and CD4^(+)/CD8^(+)groups were higher than those in the corresponding high-level groups(P<0.05).Cox analysis showed that molecular classifications,FIB,DD and CD4^(+)/CD8^(+)were influencing factors the prognosis of NAC in BC patients.Conclusion:After NAC,levels of plasma FIB,DD and CD4^(+)increase,while CD4^(+)/CD8^(+)decreases in BC patients,which are all closely related to prognosis.