| 术前白蛋白与纤维蛋白原比值对三阴性乳腺癌患者的预后影响和临床意义 |
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| 引用本文： | 吴朔,姜翠,孙涛. 术前白蛋白与纤维蛋白原比值对三阴性乳腺癌患者的预后影响和临床意义[J]. 现代肿瘤医学, 2022, 0(18): 3304-3309. DOI: 10.3969/j.issn.1672-4992.2022.18.010 |
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| 作者姓名： | 吴朔 姜翠 孙涛 |
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| 作者单位： | 中国医科大学肿瘤医院,辽宁省肿瘤医院乳腺内科,辽宁 沈阳 110042 |
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| 基金项目： | 吴阶平医学基金会临床科研专项资助基金（编号:320.6750.2020-12-21） |
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| 摘 要： | 目的:探讨术前白蛋白与纤维蛋白原比值（albumin to fibrinogen,AFR）对三阴性乳腺癌患者的预后影响和临床意义。方法:回顾性分析我院自2010年1月至2013年12月间就诊的195例三阴性乳腺癌患者。用受试者工作特性曲线（ROC）确定AFR的最佳临界值。采用卡方检验或Fisher精确检验分析比较计数资料。Kaplan-Meier方法和Log rank方法用于分析生存曲线。单因素和多因素分析（Cox比例风险回归模型）用于评估独立的预后因素。结果:ROC曲线确定AFR最佳临界值为15.00,依此分两组,即低AFR组（AFR＜15.00）和高AFR组（AFR≥15.00）。单因素和多因素分析显示AFR是三阴性乳腺癌DFS（P=0.045,HR:0.627,95%CI:0.397~0.990;P=0.026,HR:0.595,95%CI:0.377~0.940）和OS（P=0.039,HR:0.238,95%CI:0.061~0.927;P=0.001,HR:0.385,95%CI:0.221~0.670）的独立预后因素。高AFR组患者术后中位DFS和OS显著高于低AFR组患者,差异具有显著统计学意义（χ2=8.190,P=0.004;χ2=8.720,P=0.003）。散点图分析显示,AFR与ALB呈显著正相关（R2=0.028,P=0.020）,AFR与FIB呈显著负相关（R2=0.516,P＜0.000 1）。此外,对伴有淋巴管侵犯的患者,高AFR组患者比低AFR组患者术后生存时间长,预后更好。结论:术前AFR是影响患者预后的独立因素。AFR具有操作简单、易于推广、成本低、可重复性好等优点,具有潜在的临床应用价值。
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| 关 键 词： | 白蛋白/纤维蛋白原比值 三阴性乳腺癌 白蛋白 纤维蛋白原 治疗 |
The prognostic significance of albumin to fibrinogen (AFR) in predicting triple negative breast cancer patients' survival time as a promising inflammation-based prognostic marker |
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| WU Shuo,JIANG Cui,SUN Tao. The prognostic significance of albumin to fibrinogen (AFR) in predicting triple negative breast cancer patients' survival time as a promising inflammation-based prognostic marker[J]. Journal of Modern Oncology, 2022, 0(18): 3304-3309. DOI: 10.3969/j.issn.1672-4992.2022.18.010 |
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| Authors: | WU Shuo JIANG Cui SUN Tao |
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| Affiliation: | Department of Breast Medicine,Cancer Hospital of China Medical University,Liaoning Cancer Hospital & Institute,Liaoning Shenyang 110042,China. |
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| Abstract: | Objective:To study the prognostic significance of albumin to fibrinogen (AFR) in predicting triple negative breast cancer patients' survival time.Methods:The retrospective analysis included 195 patients with TNBC in this study between January 2010 and December 2013.The receiver operating characteristic curve (ROC) was used to detect the optimal cutoff value of AFR.The relationship between TNBC and clinicopathologic variables by AFR were demonstrated by Chi-square test.The survival time and survival curve were performed by Kaplan Meier method and Log rank method.The independent prognostic factors were determined by univariate and multivariate Cox's proportional hazards regression model.The hazard ratio (HR) and 95% confidence interval (CI) for the risk of recurrence were associated between AFR and TNBC cancer patients' prognosis.Results:The optimal cutoff value of AFR was 15.00 by ROC,and 195 patients were divided into:Low AFR group (AFR＜15.00) and high AFR group (AFR≥15.00).According to univariate and multivariate Cox regression survival analyses,AFR was an independent factorfor DFS (P=0.045,HR:0.627,95%CI:0.397~0.990.P=0.026,HR:0.595,95%CI:0.377~0.940,respectively)and OS (P=0.039,HR:0.238,95%CI:0.061~0.927.P=0.001,HR:0.385,95%CI:0.221~0.670,respectively).Compared with low AFR group,the median DFS and OS in high AFR group were survival longer (χ2=8.190,P=0.004.χ2=8.720,P=0.003,respectively).The scatter plot analyses revealed that a significant positive correlation between the AFR and ALB (R2=0.028,P=0.020),and a significant negative correlation between the AFR and FIB (R2=0.516,P＜0.000 1),respectively.Moreover,patients with high AFR were survival longer than those with low AFR for patients with lymph vessel invasion.Conclusion:Preoperative AFR is an independent prognostic factor for patient outcomes.AFR was easy to conduct and popularize,low cost,and repeatable predicator for preoperative clinical evaluation,and was potentially applicable to clinical practice. |
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| Keywords: | albumin/fibrinogen ratio (AFR) triple-negative breast cancer (TNBC) albumin (ALB) fibrinogen (FIB) treatment |
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