摘要
目的:探讨纤维蛋白原与白蛋白比值(FAR)与激素受体阳性/人类表皮生长因子受体2阴性(HR^(+)/HER2^(-))乳腺癌新辅助化疗(NAC)疗效的相关性。方法:回顾性分析112例首次实施NAC的HR^(+)/HER2^(-)乳腺癌患者的临床资料,首先绘制受试者工作特征(ROC)曲线确定FAR的最佳诊断截点值,并按照该值将患者分为高FAR组(≥0.073,n=38例)和低FAR组(<0.073,n=74例),采用卡方检验和秩和检验分析患者一般资料与NAC疗效的差异,采用多因素Logistic回归分析NAC疗效的相关因素。结果:FAR预测患者NAC疗效的ROC曲线下面积为0.719,最佳截断值为0.073,灵敏度与特异度分别为78.97%和88.89%。与低FAR组比较,高FAR组雌激素受体(ER)、Ki-67高表达比例较低,两组比较差异有统计学意义(均P<0.05)。低FAR组NAC有效率显著高于高FAR组(82.43%与60.52%,P<0.05)。NAC有效患者平均FAR水平显著低于无效患者,两组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,FAR≥0.073可能是HR^(+)/HER2^(-)乳腺癌患者NAC疗效的不良预测因素(OR=0.350,95%CI:0.224~0.542,P<0.05)。结论:FAR可能是预测HR^(+)/HER2^(-)乳腺癌患者NAC疗效的潜在指标,FAR<0.073的患者NAC疗效更佳。
Objective:To investigate the correlation between fibrinogen to albumin ratio(FAR)and the efficacy of neoadjuvant chemotherapy(NAC)for hormone receptor-positive/human epidermal growth factor receptor 2-negative(HR^(+)/HER2^(-))breast cancer.Methods:The clinical data of 112 HR^(+)/HER2^(-)breast cancer patients who underwent NAC for the first time were retrospectively analyzed.ROC curve was constructed to determine the optimal diagnostic cut-off value of FAR,and patients were categorized into high FAR group(≥0.073,38 cases)and low FAR group(<0.073,74 cases)according to that value.The chi-square test and log-rank test were used to analyze differences in general clinical data and NAC efficacy.Multivariate Logistic regression was used to analyze factors associated with the efficacy of NAR.Results:The area under the ROC curve for FAR to predict the efficacy of patients was 0.719,the optimal cut-off value was 0.073,and the sensitivity and specificity were 78.97%and 88.89%,respectively.Compared with the low FAR group,the proportion of estrogen receptor(ER)was higher in the high FAR group,and the proportion of high expression of Ki-67 was lower(all P<0.05).The efficiency of NAC in the low FAR group was significantly higher than that in the high FAR group(82.43%vs.60.52%,P<0.05).The mean FAR level in effective patients with NAC was significantly lower than that in ineffective patients(P<0.05).The results of multivariate Logistic regression analysis showed that FAR≥0.073 may be a poor predictor of NAC efficacy in patients with HR^(+)/HER2^(-)breast cancer(OR=0.350,95%CI:0.224 to 0.542,P<0.05).Conclusion:FAR may be a potential predictor of NAC efficacy in patients with HR^(+)/HER2^(-)breast cancer,and NAC efficacy is better in patients with FAR<0.073.
作者
崔杰
刘鑫
CUI Jie;LIU Xin(Ankang Central Hospital,Ankang 725000,China)
出处
《陕西医学杂志》
CAS
2022年第11期1351-1354,1359,共5页
Shaanxi Medical Journal
