摘要
目的分析吡咯替尼治疗人表皮生长因子受体-2(HER2)阳性乳腺癌的效果及预后。方法回顾性分析2021年5月至2022年5月中国人民解放军联勤保障部队第九○六医院已完成随访的行吡咯替尼联合化疗的350例HER2阳性乳腺癌患者临床资料。采用单因素分析检验生存组和死亡组患者预后不良的独立危险因素,以此构建列线图并外部验证。结果HER2阳性乳腺癌患者350例中,死亡78例,生存272例;预后不良组激素受体阳性、内脏转移、Ki67阳性、临床分期为Ⅲ期高于预后良好组(P<0.05);COX回归分析结果显示,内脏转移、Ki67阳性、临床分期为Ⅲ期,肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-8高表达是HER2阳性乳腺癌患者预后不良的危险因素(HR=2.708、8.209、4.038、7.465、1.066、1.739,P<0.05);预后良好组、预后不良组C-index值分别为0.938,0.946,2组校正曲线均与理想曲线拟合反应良好;区分度评价结果显示:预后良好组AUC为0.936[95%CI(0.879,0.993),P<0.001],预后不良组AUC为0.944[95%CI(0.872,0.988),P<0.001]。结论内脏转移、Ki67阳性、临床分期为Ⅲ期,TNF-α、IL-6、IL-8高表达与吡咯替尼治疗HER2阳性乳腺癌患者预后不良关系密切,且基于上述危险因素构建的列线图能够有效预测HER2阳性乳腺癌患者预后。
Objective To analyze the efficacy and prognosis of pyrrolidine in treating human epidermal growth factor receptor-2(HER2)-positive breast cancer.Methods Clinical data from 350 HER2-positive breast cancer patients treated with pyrrolidine combined with chemotherapy between May 2021 and May 2022 were retrospectively analyzed.Univariate analysis was used to identify independent risk factors for poor prognosis between the survival and deceased groups,followed by the construction and external validation of a nomogram.Results Among the 350 patients,78 died and 272 survived.The deceased group exhibited significantly higher rates of hormone receptor positivity,visceral metastasis,Ki67 positivity,and clinical stage Ⅲ compared to the survival group(P<0.05).COX regression analysis identified visceral metastasis(HR=2.708),Ki67 positivity(HR=8.209),clinical stage Ⅲ(HR=4.038),and high expression of TNF-α(HR=7.465),IL-6(HR=1.066),and IL-8(HR=1.739)as independent risk factors for poor prognosis(all P<0.05).The C-index values for the survival and deceased groups were 0.938 and 0.946,respectively,with calibration curves showing good agreement with ideal predictions.Discrimination evaluation revealed AUC values of 0.936[95%CI(0.879,0.993),P<0.001]for the survival group and 0.944[95%CI(0.872,0.988),P<0.001]for the deceased group.Conclusion Visceral metastasis,Ki67 positivity,clinical stageⅢ,and high expression of TNF-α,IL-6,and IL-8 are closely associated with poor prognosis in HER2-positive breast cancer patients treated with pyrrolidine.The nomogram based on these risk factors effectively predicts patient prognosis.
作者
金河
王梦炎
方凌云
罗灿军
Jin He;Wang Mengyan;Fang Lingyun;Luo Canjun(Department of General Surgery,906th Hospital of the Joint Service Support Force of the Chinese People's Libera-tion Army,Ningbo,Zhejiang 315040,China)
出处
《中国药物与临床》
2025年第15期992-997,共6页
Chinese Remedies & Clinics
关键词
乳腺癌
人表皮生长因子受体-2
吡咯替尼
治疗结果
预后
Breast neoplasms
Human epidermal growth factor receptor-2
Pyrrolotinib
Treatment out-come
Prognosis
