河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (12): 1423-1427.doi: 10.3969/j.issn.1007-3205.2022.12.011

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白蛋白与纤维蛋白原比值对乳腺癌预后的影响

  

  1. 1.青海省第五人民医院，青海省肿瘤医院护理部，青海 西宁  810000；2.青海省第五人民医院，青海省肿瘤医院乳腺疾病科，青海西宁  810000；3. 青海省第五人民医院，青海省肿瘤医院内分泌科，青海 西宁 810000

  • 出版日期:2022-12-25 发布日期:2023-01-11
  • 作者简介:陈莉（1976-），女，江苏盐城人，青海省第五人民医院副主任护师，从事临床护理学研究。
  • 基金资助:
    青海省自然科学基金（20160278）

Effect of the albumin to fibrinogen ratio on the prognosis of breast cancer

  1. 1.Department of Nursing, the Fifth People′s Hospital of Qinghai Province, Qinghai Provincial Tumor 
    Hospital, Xining 810000, China; 2.Department of Breast Diseases, the Fifth People′s Hospital of 
    Qinghai Province, Qinghai Provincial Tumor Hospital, Xining 810000， China; 3.Department of 
    Endocrinology, the Fifth People′s Hospital of Qinghai Province, Qinghai Provincial 
    Tumor Hospital, Xining 810000, China
  • Online:2022-12-25 Published:2023-01-11

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摘要： 目的 探讨白蛋白与纤维蛋白原比值(albumin to fibrinogen ratio, AFR)在乳腺癌患者预后评估中的作用。
方法 回顾性分析我院治疗的736例乳腺癌患者的临床资料，术前均检测AFR，依据AFR进行分组，记录患者总生存期及生存率，Cox回归进行生存分析。
结果 随访12～81个月，中位随访65个月，死亡83例（11.28%），总生存期为（66.23±12.38）个月。ROC曲线显示，术前AFR预测乳腺癌患者死亡的AUC为0.727(95%CI:0.663~0.781,P＜0.001)，临界值为13.15；736例患者分为高AFR组（＞13.15）538例、低AFR组（≤13.15）198例。低AFR组总生存期、生存率、年龄、白蛋白、白细胞、血小板低于高AFR组，纤维蛋白原、TNM分期Ⅲ期、核分级3级、有脉管瘤栓高于高AFR组，差异均有统计学意义（P＜0.05）。单因素分析显示，Fib、AFR、血小板、TNM分期、核分级、有无脉管瘤栓、雌激素/孕激素受体阳性差异有统计学意义（P＜0.05），多因素Cox回归分析结果表明，AFR≤13.15、有脉管瘤栓、TNM分期Ⅲ期是乳腺癌患者预后的危险因素，雌激素/孕激素受体阳性是保护因素。
结论 AFR降低提示乳腺癌患者预后不良，其以13.15为临界值对乳腺癌生存率具有较好的预测作用。


关键词: 乳腺肿瘤, 白蛋白类, 纤维蛋白原

Abstract: Objective To explore the role of albumin to fibrinogen ratio (AFR) in the prognosis assessment of patients with breast cancer. 
Methods Clinical data of 736 breast cancer patients treated in our hospital were retrospectively analyzed. AFR was detected before surgery, and they were grouped according to AFR. The overall survival (OS) and survival rate of patients were recorded, and Cox regression was used for survival analysis. 
Results The follow-up period ranged from 12 to 81 months, with a median follow-up period of 65 months. Eighty-three patients (11.28%) died, and the overall survival period was (66.23 ± 12.38) months. The receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) of preoperative AFR in predicting the death of breast cancer patients was 0.727 (95%CI: 0.663-0.781, P＜0.001), and the cut-off value was 13.15. In addition, 736 patients were divided into high AFR group (＞13.15, n=538) and low AFR group (≤13.15, n=198). The OS, survival rate, age, albumin, leukocytes, and platelets of the low AFR group were lower than those of the high AFR group, while fibrinogen (FIB), TNM stage Ⅲ, nuclear grade 3, and vascular tumor thrombus were higher than those of the high AFR group, suggesting significant differences (P＜0.05). Univariate analysis showed that FIB, AFR, platelet, TNM staging, nuclear grade, presence or absence of vascular tumor thrombus, and difference in positive estrogen receptor/progesterone receptor (ER/PR) were statistically significant (P＜0.05). The results of multivariate Cox regression analysis showed that AFR≤13.15, vascular tumor thrombus and TNM stage Ⅲ were the risk factors for the prognosis of breast cancer patients, and positive ER/PR was the protective factor. 
Conclusion The decrease in AFR indicates a poor prognosis for breast cancer patients. AFR with 13.15 as a critical value has a good predictive effect on breast cancer survival rate. 


Key words: breast neoplasms, albumins, fibrinogen

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