网状蛋白1C水平与三阴性乳腺癌新辅助化疗疗效的相关性研究

目的 探究三阴性乳腺癌(TNBC)患者外周血单个核细胞中网状蛋白1C(RTN-1C)表达水平与新辅助化疗疗效的关系。方法 选取154例TNBC患者作为研究对象。收集所有受试者年龄、月经状态、病理类型、T_NM分期、组织学分级和Ki-67表达>30%情况、肿瘤直径。抽取TNBC患者化疗前(T₀)、化疗7 d(T₁)、化疗14 d(T₂)和化疗21 d(T₃)的空腹肘正中静脉血，用Ficoll密度梯度离心法分离外周血中单个核细胞，蛋白质免疫印迹法检测单个核细胞中RTN-1C表达水平。受试者工作特征(ROC)曲线评价RTN-1C判断新辅助化疗疗效的效能，Logistic回归分析新辅助化疗疗效的风险因素，构建列线图回归模型预测新辅助化疗后病理学完全缓解，一致性指数(C-index)、校准曲线和决策曲线评估模型效能。结果 根据新辅助化疗疗效分为完全缓解组(n=47)和未完全缓解组(n=107)。在T₁和T₃完全缓解组的RTN-1C均低于未完...

The correlation between the level of reticulin 1C in peripheral blood mononuclear cells and the efficacy of neoadjuvant chemotherapy for triple negative breast cancer

Objective To explore the relationship between the expression level of reticulin 1C (RTN-1C) in peripheral blood mononuclear cells of patients with triple negative breast cancer (TNBC) and the efficacy of neoadjuvant chemotherapy. Methods A total of 154 TNBC patients were selected as the study subjects. Patients were divided into the complete remission group (n=47) and the incomplete remission group (n=107) according to the efficacy of neoadjuvant chemotherapy. Data of age, menstrual status, type of pathology, TNM stage, histological grade, Ki-67 expression >30% and tumour diameter were collected from all subjects. Fasting elbow venous blood samples were collected from TNBC patients before chemotherapy (T₀), 7 days after chemotherapy (T₁), 14 days after chemotherapy (T₂) and 21 days after chemotherapy (T₃). Peripheral blood mononuclear cells were isolated by Ficoll density gradient centrifugation. The expression levels of RTN-1C in mononuclear cells were detected by Western blot assay. The receiver operating characteristic curve (ROC) was used to evaluate the efficacy of RTN-1C in determining neoadjuvant chemotherapy efficacy. Logistic regression was used to analyse risk factors for neoadjuvant chemotherapy efficacy. Nomogram regression models were constructed to predict complete remission of pathology after neoadjuvant chemotherapy, and consistency index (C-index), calibration curves and decision tree curves were used to assess model efficacy. Results The relative expression levels of RTN-1C were lower at T₁ and T₃ in the complete remission group than those in the incomplete remission group (P<0.05). The relative expression levels of RTN-1C at T₀, T₁ and T₂ decreased over time in the 2 groups (P<0.01). The area under the ROC curve (AUC) of T₃-RTN-1C was higher than T₀-RTN-1C, T₁-RTN-1C and T₂-RTN-1C in judging pathological complete remission after neoadjuvant chemotherapy (P<0.01). Logistic regression analysis showed that T₃-RTN-1C>0.91 (OR=12.178, 95%CI: 4.796-30.924), N1 or N2 (OR=2.180, 95%CI: 1.100-4.322) and histological grade Ⅲ (OR=3.609, 95%CI: 1.453-8.969) were independent risk factors for pathological incomplete remission after neoadjuvant chemotherapy (P<0.05). Model A (constructed by N stage, histological grade and T₃-RTN-1C) had a high degree of coincidence between the fitting curve and the ideal curve, while model B (constructed by N stage and histological grade) had a poor degree of coincidence between the fitting curve and the ideal curve. The C-index of model A and model B were 0.866 and 0.772, respectively. When the threshold probability was higher than 0.40, the net benefit of model A in judging pathological complete response after neoadjuvant chemotherapy was higher than that of model B. Conclusion The model constructed by N stage, histological grade and T₃-RTN-1C has a high degree of differentiation, accuracy and clinical application value in judging pathological complete response after neoadjuvant chemotherapy.