术前CD4+CD8+、FAR及糖类抗原水平与乳腺癌改良根治术后预后关系研究

Relationship of Preoperative CD4+CD8+,FAR and Carbohydrate Antigen Levels with the Prognosis in Patients Underwent Modified Radical Mastectomy for Breast Cancer

目的分析术前CD4+CD8+、纤维蛋白原与白蛋白的比值(FAR)及糖类抗原125(CA125)水平与乳腺癌改良根治术后预后关系。方法选择医院2019年1月~2021年1月诊治的乳腺癌患者的患者136例,将其纳入研究组。按照1∶1要求,在同期选择体检健康受试女性136例,将其纳入对照组。在治疗前1d,抽取2组外周静脉血3ml,使用全自动电化学发光分析仪检测CA125水平;使用流式细胞仪检测CD4+、CD8+,计算CD4+/CD8+比值;使用全自动生化凝血分析仪检测FAR水平。研究组患者进行改良根治术治疗,随访1年统计患者无复发生存情况。比较两组血清CD4+/CD8+、FAR、CA125水平;探讨术前血清CD4+/CD8+、FAR、CA125水平诊断乳腺癌改良根治术后无复发生存效能及关系。结果研究组患者术前血清CD4+/CD8+、FAR水平低于对照组(P<0.05),CA125水平高于对照组(P<0.05)。随访发现生存无复发患者75%,复发生存患者25%。CD4+/CD8+诊断乳腺癌改良根治术后无复发生存中敏感度29.4%、特异度69.7%、诊断界值1.05、约登指数-0.09、阳性预测值24.4、阴性预测值74.7;FAR诊断乳腺癌改良根治术后无复发生存中敏感度58.8%、特异度87.3%、诊断界值8.12、约登指数-0.09、阳性预测值60.6、阴性预测值86.4;CA125诊断乳腺癌改良根治术后无复发生存中敏感度70.6%、特异度20.6%、诊断界值22.13、约登指数-0.088、阳性预测值22.9、阴性预测值67.7。术前血清CD4+/CD8+、FAR与乳腺癌改良根治术预后呈正相关(P<0.05)。血清CA125水平与预后呈负相关(P<0.05)。结论术前CD4+CD8+、FAR及糖类抗原水平与乳腺癌改良根治术后预后关系关系密切,建议密切关注。

Objective To analyze the relationship of preoperative CD4+CD8+,fibrinogen-to-albumin ratio(FAR)and carbohydrate antigen 125(CA125)levels with the prognosis in patients underwent modified radical mastectomy for breast cancer.Methods At a scale of 1∶1,136 patients with breast cancer and 136 healthy individuals in our hospital from January 2019 to January 2021 were enrolled as study group and control group,respectively.One day before treatment,3ml of peripheral venous blood was collected to detect serum CA125 levels by automatic chemiluminescence immune analyzer.The automatic biochemical analyzer was used to detect the CD4+,CD8+and FAR,and the ratio of CD4+/CD8+was calculated.Patients in study group received modified radical mastectomy and one-year follow-up.The recurrence free survival time was recorded.Serum CD4+/CD8+,FAR and CA125 levels were compared between groups,then the value of preoperative serum CD4+/CD8+,FAR and CA125 levels in evaluating the recurrence-free survival after modified radical mastectomy for breast cancer was evaluated,and the correlation analysis was also performed.Results The preoperative serum CD4+/CD8+and FAR levels in study group were lower than those of control group(P<0.05),and CA125 levels were higher than those of control group(P<0.05).Follow-up found that the non-recurrence rate was 75%and recurrence rate was 25%.In predicting the recurrence-free survival after modified radical mastectomy for breast cancer,the sensitivity,specificity,diagnostic value,Youden index,positive predictive value and negative predictive value were 29.4%,69.7%,1.05,-0.09,24.4 and 74.7 under CD4+/CD8+curve,those were 58.8%,87.3%,8.12,-0.09,60.6 and 86.4 under FAR curve,and were 70.6%,20.6%,22.13,-0.088,22.9 and 67.7 under CA125 curve.Serum CD4+/CD8+and FAR were positively correlated with prognosis after modified radical mastectomy(P<0.05).Serum CA125 level was negatively correlated with prognosis(P<0.05).Conclusion Preoperative CD4+CD8+,FAR and carbohydrate antigen levels are closely related to prognosis of breast cancer patients after modified radical mastectomy.