术前血浆纤维蛋白原水平是绝经后妇女乳腺癌手术后长期生存的风险因素

Preoperative plasma fibrinogen level is a risk factor for the long-term survival of postmenopausal women after surgery for breast cancer

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MATURITAS

影响因子:3.6

分区:医学2区 / 妇产科学2区老年医学3区

发表日期:2024 Nov

作者: Jinxi Hu, Dong Xu, Hanqian Zeng, Yijun Chen, Xiaoli Zhu

DOI: 10.1016/j.maturitas.2024.108108

摘要

研究表明，纤维蛋白原水平与乳腺癌患者的预后有关。然而，纤维蛋白原水平易受到月经周期的波动影响。本研究探讨了术前血浆纤维蛋白原水平与绝经后乳腺癌妇女手术后预后的关系。对855例绝经后乳腺癌患者进行了为期10年的随访。采用Cox比例风险模型进行单变量和多变量分析，以识别具有显著预后价值的因素。随访中位数为77个月（51-105个月），最长达142个月。随访期间，记录到65例死亡（7.6%）。多变量Cox回归分析结果显示，术前血浆纤维蛋白原水平（风险比[HR]=1.615，95%置信区间[CI]：1.233-2.115）和年龄（HR=1.626，95%CI：1.250-2.116）是术后10年总生存期的独立风险因素，而内分泌治疗（HR=0.414，95%CI：0.202-0.846）则是独立的保护因素。多变量分析还显示，术前血浆纤维蛋白原水平是术后10年无病生存（HR=1.398，95%CI：1.137-1.719）和远处转移无病生存（HR=1.436，95%CI：1.153-1.787）的独立风险因素。升高的术前血浆纤维蛋白原水平与乳腺癌术后患者较差的长期预后相关。

Abstract

Studies have indicated an association between fibrinogen levels and the prognosis of breast cancer patients. However, fibrinogen levels are notably susceptible to fluctuations due to the menstrual cycle. This study explored the relationship between preoperative plasma fibrinogen levels and the prognosis of postmenopausal breast cancer women after surgery.855 patients with postmenopausal breast cancer were monitored for 10 years. Cox proportional hazards regression models were used to perform univariate and multivariate analyses to identify factors that are of substantial prognostic value.The median follow-up was 77 months (51-105 months), and the maximum 142 months. Over the follow-up period, 65 deaths (7.6 %) were recorded. Multivariate Cox regression results show that preoperative plasma fibrinogen level (hazard ratio [HR] =1.615, 95 % confidence interval [CI]: 1.233-2.115) and age (HR = 1.626, 95%CI: 1.250-2.116) were independent risk factors for 10-year overall survival after surgery in postmenopausal breast cancer patients, while endocrine therapy (HR = 0.414, 95%CI: 0.202-0.846) was an independent protective factor. Multivariate Cox regression results also show preoperative plasma fibrinogen level was an independent risk factor for 10-year disease-free survival (HR = 1.398, 95 % CI: 1.137-1.719) and 10-year distant metastasis-free survival (HR = 1.436, 95%CI: 1.153-1.787).Elevated pretreatment plasma fibrinogen levels are associated with a poorer long-term prognosis in postmenopausal breast cancer patients following surgical treatment.