Abstract:
The study explored the impact of pretreatment serum albumin-to-alkaline phosphatase ratio (AAPR) and changes in tumor blood supply on pathological complete response (pCR) in breast cancer (BC) patients following neoadjuvant chemotherapy (NACT). Additionally, a nomogram for predicting pCR was established and validated. The study included BC patients undergoing NACT at Yongchuan Hospital of Chongqing Medical University from January 2019 to October 2023. We analyzed the correlation between pCR and clinicopathological factors, as well as tumor ultrasound features, using chi-square or Fisher\'s exact test. We developed and validated a nomogram predicting pCR based on regression analysis results. The study included 176 BC patients. Logistic regression analysis identified AAPR [odds ratio (OR) 2.616, 95% confidence interval (CI) 1.140-5.998, P = 0.023], changes in tumor blood supply after two NACT cycles (OR 2.247, 95%CI 1.071-4.716, P = 0.032), tumor histological grade (OR 3.843, 95%CI 1.286-10.659, P = 0.010), and HER2 status (OR 2.776, 95%CI 1.057-7.240, P = 0.038) as independent predictors of pCR after NACT. The nomogram, based on AAPR, changes in tumor blood supply after two NACT cycles, tumor histological grade, and HER2 status, demonstrated a good predictive capability.
摘要:
本研究探讨了治疗前血清白蛋白与碱性磷酸酶比值(AAPR)和肿瘤血供变化对乳腺癌(BC)患者新辅助化疗(NACT)后病理完全缓解(pCR)的影响。此外,建立并验证了预测pCR的列线图.该研究包括2019年1月至2023年10月在重庆医科大学永川医院接受NACT的BC患者。我们分析了pCR与临床病理因素之间的相关性,以及肿瘤的超声特征,使用卡方或费希尔精确检验。我们开发并验证了基于回归分析结果的预测pCR的列线图。该研究包括176例BC患者。Logistic回归分析确定AAPR[优势比(OR)2.616,95%置信区间(CI)1.140-5.998,P=0.023],两个NACT周期后肿瘤血液供应的变化(OR2.247,95CI1.071-4.716,P=0.032),肿瘤组织学分级(OR3.843,95CI1.286-10.659,P=0.010),和HER2状态(OR2.776,95CI1.057-7.240,P=0.038)是NACT后pCR的独立预测因子。列线图,基于AAPR,两个NACT周期后肿瘤血液供应的变化,肿瘤组织学分级,和HER2状态,表现出良好的预测能力。