| Background:Breast cancer is the malignant tumor with the highest incidence of women,and the mortality rate is second only to lung cancer.The high mortality rate of breast cancer is mainly related to postoperative recurrence.With the improvement of the level of diagnosis and treatment,about 90%of patients can be found early and concurrently with surgical treatment,but the risk of recurrence after surgery is still as high as 5%-30%.It has been found that the stage and type of breast cancer are closely related to the recurrence of breast cancer after surgery.Due to the large heterogeneity of the tumor,most of the recurring factors are still being explored.Like other malignant tumors,the occurrence,development and metastasis of breast cancer are the result of multiple genes and multiple factors.In addition to genetic,age,menstrual history,marriage and childbirth and other risk factors,epidemiological studies have shown that obesity and high-fat diet are closely related to the development of breast cancer and affect the prognosis of postoperative patients with breast cancer.In recent years,diet and obesity have gradually attracted attention because of their close association with tumorigenesis.In order to meet the needs of rapid proliferation and other life activities,tumor cells increase their intake of nutrients such as lipids,which is manifested by an increase in de novo synthesis of fatty acids.A variety of lipid molecules and their metabolic intermediates can participate in cell signal transduction,inflammation and vascular regulation and other life activities,and are closely related to tumor cell proliferation and cell adhesion.Blood lipids are involved in regulating many physiological activities,such as energy storage,structure,apoptosis and signal transduction.Therefore,abnormal lipid metabolism is closely related to the occurrence,development,invasion and metastasis of breast cancer and other malignant biological behaviors.According to research reports,dyslipidemia is the main component of metabolic syndrome and plays an important role in the development of various tumors,including breast cancer,prostate cancer,ovarian cancer and kidney cancer.Studies have shown that hyperlipidemia can increase the incidence,growth rate and metastasis rate of breast cancer.Recent studies have also found that blood lipids also affect the infiltration of immune cells in the tumor microenvironment,which in turn affects the body’s immune status.Since the removal of small residual lesions after surgery depends on the body’s immune system,exploring the correlation between blood lipids and the body’s immune status,and even the prognosis,can help to better assess the recurrence and prognosis of postoperative patients with breast cancer.Objective:Explore the related factors that affect the prognosis of postoperative patients with breast cancer,and clarify the possible impact of blood lipids on the body’s immune status and prognosis.Method:This study collected 110 cases of breast cancer patients who were admitted to the First Hospital of Jilin University from December 2013 to December 2018 and were diagnosed with invasive breast cancer by histopathology,standardized treatment and complete clinical data after surgery.According to the results of blood lipid and lymphocyte subgroup test at the same postoperative admission,explore the correlation between the clinical characteristics of breast cancer patients,blood lipid levels and lymphocyte subgroups,and use SPSS 22.0 software to analyze the correlation between blood lipid levels,lymphocyte subsets and patient prognosis.Results:1.Univariate analysis of the prognostic correlation of postoperative patients with breast cancer:(1)Postoperative patients with breast cancer who have older age and later stages are associated with shorter disease free survival(DFS)and overall survival(OS).(2)Increased levels of apolipoprotein a(Apo a)are associated with shorter DFS and OS in postoperative patients with breast cancer.(3)the correlation between the prognosis of breast cancer and immune status,the results showed the CD4/CD8 ratio was positively related with DFS of postoperative patients with breast cancer(P=0.001),CD4/CD8 ratio of low and high groups DFS were 67.42 months and 107.5 months,and the ratio of CD4/CD8 is positively correlated with OS of postoperative patients with breast cancer(P=0.002),OS in CD4/CD8 ratio of low and high groups were 98.86 months and 117.3 months respectively.2.COX multivariate analysis of the correlation between prognosis of postoperative patients with breast cancer:Installment and Apo a associated with DFS in postoperative patients with breast cancer,the later stage of postoperative patients with breast cancer risk of recurrence is 5.31 times of the earlier stage patients(P=0.006),the higher level of Apo a in postoperative patients with breast cancer risk of recurrence was 3.18 times that of Apo a lower levels.The later stage and lower Apo a are independent risk factors for DFS in postoperative patients with breast cancer(P<0.05).3.Correlation analysis of blood lipid and clinical characteristics of postoperative patients with breast cancer showed that body weight was positively correlated with the level of low density lipoprotein(LDL)(P=0.001).Weight is positively correlated with total cholesterol(TC)level(P=0.015);BMI was positively correlated with triglyceride(TG)level(P=0.015),and stage was negatively correlated with TG level(P=0.048).4.The clinical characteristics of postoperative patients with breast cancer were correlated with immune status,and the results showed that body weight was negatively correlated with CD4/CD8(P=0.045).5.The results showed that the higher the LDL,the lower the total T cells(CD3~+T)(P=0.042),and the apolipoprotein B(ApoB)level was negatively correlated with CD3~+T cells(P=0.007).TG level was negatively correlated with CD4~+T cells(P=0.006);Lipoprotein a(Apo a)was negatively correlated with NK level(P=0.029).Lipoprotein A1(Apo A1)was positively correlated with NK level(P=0.027).Conclusion:1.Age,stage,Apo a and CD4/CD8 ratio were correlated with DFS and OS in postoperative patients with breast cancer.Stage and Apo a are independent risk factors for DFS in postoperative patients with breast cancer.2.LDL and Apo B were negatively correlated with the total T cell count of postoperative patients with breast cancer,TG level was negatively correlated with CD4~+T cells,Apo a level was negatively correlated with NK level,and Apo A1 level was positively correlated with NK level.There may be a certain correlation between blood lipid and lymphocyte subsets in postoperative patients with breast cancer. |
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