High plasma fibrinogen is correlated with poor response to trastuzumab treatment in HER2 positive breast cancer.
High plasma fibrinogen is correlated with poor response to trastuzumab treatment in HER2 positive breast cancer.
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DOI：
10.1097/md.0000000000000481
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发表时间：
2015-02
期刊：
影响因子：
1.6
通讯作者：
Liang B
中科院分区：
文献类型：
--
作者：
Liu YL;Lu Q;Liang JW;Xia Y;Zhang W;Hu BQ;Shang FF;Ji YR;Wang J;Wang Q;Liang B
补充数字内容在正文中可用，部分HER-2阳性乳腺癌患者曲妥珠单抗治疗失败。最近的报道表明，乳腺癌患者的血浆凝血参数与临床特征之间存在相关性。本研究的目的是分析凝血参数在曲妥珠单抗治疗患者中的作用。对2006-2010年间接受曲妥珠单抗治疗的乳腺癌患者的凝血参数进行了回顾性研究。分析凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、D-二聚体(DD)等凝血指标与临床指标的相关性。采用Kaplan-Meier分析和Cox回归风险模型评价其对预后的影响。收集102例接受曲妥珠单抗治疗的乳腺癌住院患者，并对其进行随访。所有患者均为HER-2阳性的晚期乳腺癌，中位年龄为45岁。曲妥珠单抗治疗无效组PT、APTT、TT延长，Fib、DD升高。但显著增加的只有Fib。高Fib状态(Fib 和GT； 2.88PTEN g/L)与病理分级等临床特征相关，与 表达呈负相关。更重要的是，在高纤维乳腺癌患者中发现曲妥珠单抗治疗的无病生存率(DFS)和总生存率(OS)较低。这项回顾性研究表明，高Fib状态与曲妥珠单抗治疗反应差有关。我们的研究结果表明，对于HER-2阳性的乳腺癌患者，在曲妥珠单抗治疗之前，Fib &> 2.88应该提醒医生考虑使用降低Fib水平的预治疗。
Supplemental Digital Content is available in the text Some of HER-2 positive breast cancer patients failed to trastuzumab treatment. Recent reports have indicated the correlation between plasma coagulation parameters and clinical characteristics in breast cancer. The aim of this study was to analyze the role of coagulation parameters in trastuzumab treated patients. Coagulation parameters from trastuzumab treated breast cancer patients were retrospectively studied from 2006 to 2010. The correlation between routine coagulation levels and clinical characteristics were analyzed, including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib) and D-dimer (DD). The Kaplan–Meier analysis and Cox regression hazard model were applied to assess their effect on prognosis. Totally 102 hospitalized breast cancer patients who received trastuzumab were collected and followed-up. All patients were HER-2 positive advanced breast cancer, with a median age of 45 years old. Extended PT, APTT, and TT were found in trastuzumab treatment non-effective group, as well as increased Fib and DD. But significant increase was only found in Fib. High Fib status (Fib > 2.88 g/L) was correlated with clinical characteristics, such as pathological grade, and reversely correlated with PTEN expression. More importantly, poor disease-free survival (DFS) and overall survival (OS) to trastuzumab treatment were found in high Fib breast cancer patients. This retrospective study suggests high Fib status was correlated with poor treatment response to trastuzumab. Our findings indicated that Fib > 2.88 should alert physicians to consider a pretreatment for reducing Fib levels before trastuzumab treatment in HER-2 positive breast cancer patients.