Prognostic Analysis Of Dual-Target Therapy For Advanced Breast Cancer And Correlation Study Of ESR And CRP

Objective:To investigate the correlation between erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)and the efficacy of dual-target therapy in human epidermal growth factor receptor 2(HER-2)positive advanced breast cancer patients,and analyze the factors affecting progression free survival(PFS)of patients.Methods:Clinical data of 60 female patients with HER2-positive advanced breast cancer who met the inclusion and exclusion criteria and received dual-target therapy with trastuzumab combined with pertuzumab in Inner Mongolia Forestry General Hospital from October 2020 to June 2022 were collected,including age,estrogen receptor(ER)status,progesterone receptor(PR)status,pathological type,lymph node metastasis,distant metastasis site,adjuvant chemotherapy,ESR value,CRP value.The optimal cut-off points of ESR and CRP were determined by ROC curve,and were divided into high and low value groups according to the optimal cut-off points.χ2 test was used to compare the correlation between the high and low values of ESR and CRP and the basic clinical data.Wilcoxon rank sum test was used to determine the changes of ESR and CRP levels before and after treatment.Kaplan-Meier curve was drawn,and the influencing factors of PFS were identified by Log-rank univariate analysis and COX multivariate analysis.The combined index of ESR-CRP was divided into low,medium and high risk groups.χ2 test was used to compare the correlation between each risk group and basic clinical data.COX regression analysis of PFS was performed for each risk group.Results:(1)ESR and CRP values decreased after treatment in partial response group and stable disease group,while ESR and CRP values increased after treatment in progressive disease group.There were statistically significant differences in ESR and CRP values among therapeutic effect groups before and after treatment(P<0.05).(2)Univariate analysis found that ER status,multiple distant metastatic sites,ESR value and CRP value were the influencing factors of PFS(P<0.05).Factors with statistical significance in univariate analysis were included in multivariate analysis.Multiple distant metastatic sites(HR=5.684,95%CI=1.102-29.321,P=0.038),ESR value(HR=6.281,95%CI=1.217-32.431,P=0.028),CRP value(HR=10.220,95%CI=1.229-84.989,P=0.032)were the influencing factors of PFS.(3)Univariate analysis showed that the high risk group was the influencing factor of PFS(HR=5.266,95%CI=1.176-23.584,P=0.030),and the progression free survival rate in the low risk group was higher than that in the medium risk group and high risk group,the difference was statistically significant(P<0.05).Conclusions:(1)Changes in ESR and CRP levels before and after dual-target therapy have certain predictive value for the efficacy of women with HER-2 positive advanced breast cancer.(2)High ESR and CRP before dual-target therapy are the influencing factors for PFS in women with HER-2 positive advanced breast cancer,which may have certain value in predicting the prognosis of patients.