Influencing Factor Analysis Of Neoadjuvant Chemotherapy On Blood Lipid In Patients With Breast Cancer

Objective:By collecting the blood lipid level and clinical medical records of 299 breast cancer patients receiving neoadjuvant chemotherapy in recent three years,we will study the effect of neoadjuvant chemotherapy on blood lipid level in patients with breast cancer and explore the influencing factors of blood lipid level changes during neoadjuvant chemotherapy,so as to provide reference and treatment basis for early identification of cardiovascular disease risk factors during neoadjuvant chemotherapy,reduction of recurrence and metastasis of tumors,and improvement of prognosis.Methods:The patients with breast cancer who received neoadjuvant chemotherapy from June2015 to March 2018 in the Breast Diseases Center of Affiliated Hospital of Qingdao University were selected as the research objects.The clinical and pathological data of the patients were retrospectively summarized.The changes of blood lipids before and after receiving NAC were analyzed by paired t test.The elevation and decrease of blood lipid indexes were taken as dependent variables,Chi-square test and binary Logistic test were used to analysis the risk factors affecting the change of blood lipid level.Results:1.After neoadjuvant chemotherapy,the levels of TG,TC and LDL-C in the patients increased[(2.26±1.77)mmol/L vs(1.47±1.13)mmol/L?(5.81±1.20)mmol/L vs(5.17±1.07)mmol/L?(3.42±0.89)mmol/L vs(2.87±0.77)mmol/L,t=-10.02?-9.80?-9.36],HDL-C levels were lower than before chemotherapy [(1.28±0.33)mmol/L vs(1.45±0.32)mmol/L,t=9.28],All P values were less than 0.05,the difference was significant.2.Univariate analysis showed that 230 patients had elevated TG level and 89 patients had decreased TG level after receiving NAC,body mass index(?2=5.655,P=0.017),pathological type of tumors(?2=7.676,P=0.022)and chemotherapy(?2=10.747,P=0.005)were the related factors affecting the elevation of serum TG level after receiving NAC.The P value was lower than 0.05,and the difference was significant;There were 198 patients with decreased serum TC level and 101 patients with decreased,Positive vascular invasion was correlated with increased serum TC level after NAC(?2=4.911,P=0.027),P value has statistical significance;There were 94 patients with increased serum HDL-C level after NAC,205 patients with decreased serum HDL-C level,menstrual status(?2=9.608,P=0.002),molecular typing of tumors(?2=8.626,P=0.003) were correlated with decreased serum HDL-C level after NAC,similarly,P value has statistical significance;There were 199 cases elevated and 100 cases decreased with LDL-C level after NAC,the elevated proportion of serum LDL-C level in non-menopausal patients after NAC was higher than that in menopausal patients,the difference was statistically significant(?2=5.134,P=0.023),and it was considered that whether menopause was related to elevated LDL-C level.However,age,history of abortion,histological grading of tumors,P53 status,lymph node status,anatomical grading,pathological complete response(p CR),efficacy of chemotherapy,nausea and vomiting during chemotherapy were not related to the changes of blood lipid levels..3.Multivariate analysis showed that normal BMI(OR=2.079,P=0.024),invasive non-specific cancer(OR=3.881,P=0.003)and anthracycline combined paclitaxel chemotherapy(OR=3.508,P=0.001)were independent risk factors for the increase of TG level;Positive vascular invasion was an independent risk factor for TC change;premenopause(OR=2.659,P=0.001),and anthracycline combined paclitaxel chemotherapy(OR=3.508,P=0.001)were independent risk factors for TC change.Triple negative breast cancer molecular typing(OR = 3.142,P = 0.001)was an independent risk factor for the reduction of HDL-C level.Conclusion1.Dysfunction of lipid metabolism in breast cancer patients after neoadjuvant chemotherapy.2.Patients with normal BMI,invasive non-special cancer of pathological type,anthracycline combined with purple shirt,non-menopausal,molecular typing negative and positive vascular invasion can be used as risk factors of dyslipidemia.They can be regarded as the theoretical basis and reference for preventing and treating cardiac diseases of tumors,reducing recurrence of tumors and improving prognosis.