三阴性乳腺癌新辅助化疗后肝功能异常的影响因素分析

Analysis of influencing factors of abnormal liver function after neoadjuvant chemotherapy for triple negative breast cancer

目的分析三阴性乳腺癌(TNBC)新辅助化疗后肝功能异常的影响因素。方法选取2019年6月至2022年6月在湖北省十堰市太和医院进行新辅助化疗的TNBC患者194例,以新辅助化疗后有无肝功异常将其分为研究组(86例)和对照组(108例)。比较两组临床相关指标,运用logistic回归模型分析筛选TNBC患者新辅助化疗后肝功能异常的影响因素。结果194例患者中肝功能异常发生率为44.3%(86/194)。研究组年龄、体重指数(BMI)、绝经患者占比、脂肪肝患者占比、糖尿病患者占比、采用TAC化疗方案患者占比和乙型肝炎表面抗原阳性患者占比高于均对照组,差异有统计学意义(P<0.05)。多因素分析结果显示,BMI(OR=1.494,95%CI:1.043~2.246)、糖尿病(OR=2.983,95%CI:1.619~5.547)、脂肪肝(OR=1.468,95%CI:1.011~2.129)、TAC化疗方案(OR=5.574,95%CI:2.817~9.997)及乙型肝炎表面抗原阳性(OR=2.724,95%CI:1.134~5.581)是TNBC患者新辅助化疗发生肝功能异常的影响因素(P<0.05)。结论多种因素可导致TNBC患者新辅助化疗后发生肝功能异常,应采取体化的干预,降低肝功能异常的发生率,保障治疗的顺利进行。

Objective To analyze the influencing factors of abnormal liver function after neoadjuvant chemotherapy in triple negative breast cancer(TNBC).Methods A total of 194 TNBC patients received neoadjuvant chemotherapy in Taihe Hospital,Shiyan,Hubei Province from June 2019 to June 2022 were selected and divided into study group(86 cases)and control group(108 cases)according to whether they had abnormal liver function after neoadjuvant chemotherapy.The clinical relevant indicators of the two groups were compared.Logistic regression model was used to analyze the influencing factors of abnormal liver function in TNBC patients after neoadjuvant chemotherapy.Results The incidence of abnormal liver function in 194 patients was 44.3%(86/194).The age,body mass index(BMI),proportion of menopausal patients,proportion of fatty liver patients,proportion of diabetes mellitus patients,proportion of TAC patients,and proportion of hepatitis B surface antigen positive patients in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that BMI(OR=1.494,95%CI:1.043-2.246),diabetes mellitus(OR=2.983,95%CI:1.619-5.547),fatty liver(OR=1.468,95%CI:1.011-2.129),TAC chemotherapy regimen(OR=5.574,95%CI:2.817-9.997),and hepatitis B surface antigen positive(OR=2.724,95%CI:1.134-5.581)were the influencing factors of abnormal liver function after neoadjuvant chemotherapy in TNBC patients(P<0.05).Conclusion Various factors can lead to abnormal liver function in TNBC patients after neoadjuvant chemotherapy.Physical intervention should be taken to reduce the incidence of abnormal liver function and ensure the smooth progress of treatment.