Peripheral blood of Neutrophil-to-Lymphocyte ratio (NLR), carcinoma embryonic antigen (CEA), cancer antigen 125 (CA125) and cancer antigen 15–3 (CA15-3) could be used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory cell ratio and tumor markers for postoperative breast cancer patients. Clinical data concerning 190 breast cancer patients who underwent radical surgery in Zhejiang Provincial Hospital of Chinese Medicine from 2013 and 2016 were retrospectively analyzed. The effects of NLR, CEA, CA125, and CA153 on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ 2 test and Cox regression analyses. There were totally 32 of 190 patients had local or distant metastases within 5 years after surgery. The peripheral blood NLR, CEA, CA125, and CA15-3 areas under the curve (AUC) were 0.8272, 0.667, 0.702, and 0.715, and the optimal cutoff values were 2.65, 1.47, 10.55, and 10.55, respectively. Univariate analysis and Kaplan-Meier survival analysis revealed that the serum NLR, CEA, CA125, and CA15-3 were related to postoperative 5-year DFS ( P < .05). In addition, multivariate survival analysis identified the following independent prognostic factors: NLR ( P < .001), CA125 ( P = .045) and ki-67 ( P = .020). Preoperative serum inflammatory biomarker of NLR and tumor marker of CA125 have potential prognostic value for breast carcinoma.
BackgroundInvasive micropapillary carcinoma (IMPC) and secretory carcinoma of the breast (SCB) are relatively rare types of breast cancer. IMPC is usually associated with high incidence of lymphovascular invasion, lymph node metastasis and poor prognosis. While SCB usually carries a relatively favorable prognosis, cases of axillary and distant metastases have been reported. Clinicians generally adopt systemic treatments based on the histopathological findings of the patients to improve the prognosis, but there is currently no consensus on the optimal treatment for these two types of cancer.Case presentationWe treated a 50‐year‐old woman with lung cancer history who presented with a single lump in each breast. Following bilateral breast-conserving surgery, the diagnosis of SCB of the left breast and IMPC of the right breast was confirmed with immunohistochemistry. It is worth noting that the pathological results of left lung adenocarcinoma centered on micropapillary-type was same as the invasive micropapillary component of right breast.ConclusionsWe reported this case of bilateral primary relatively-rare-form breast cancer for its extremely rare occurrence and there are less than 20 cases of SCB reported worldwide till now. It is also significative to distinguish this primary tumor of right breast from metastatic cancer. Our histopathologic diagnosis and synthetical therapy scheme will provide material for SCB and IMPC. To facilitate the diagnosis and prognosis of such relatively rare tumors, more cases will need to be reported.
The extensive and intricate relationships between circadian rhythm and cancer have been reported in numerous studies. However, in breast cancer (BC), the potential role of circadian clock-related genes (CCRGs) in prognosis prediction has not been fully clarified. The transcriptome data and clinical information were downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus databases. A CCRGs-based risk signature was established by differential expression analysis, univariate, Lasso and multivariate Cox regression analyses. we conducted a gene set enrichment analysis (GSEA) between groups. A nomogram integrating independent clinical factors and risk score was generated and evaluated by calibration curves and decision curve analysis (DCA). Differentially expression analysis revealed 80 differentially expressed CCRGs, and 27 of them were significantly associated with the overall survival (OS) of BC. BC can be classified into 4 molecular subtypes with significant differences in prognosis based on the 27 CCRGs. Three prognostic CCRGs, including desmocollin 1 (DSC1), LEF1, and protocadherin 9 (PCDH9), were identified to be independent risk factors of BC prognosis and were used to construct a risk score model. BC patients were divided into high- and low-risk groups, and there were significant differences in prognosis between the 2 groups both in the training and validation cohorts. It was found that patients in different groups of race, status, or T stage had significant levels of risk score. Furthermore, patients of different risk levels exhibit varying degrees of sensitivity to vinorelbine, lapatinib, metformin, and vinblastine. GSEA showed that in the high-risk group, immune response-related activities were dramatically repressed whereas cilium-related processes were significantly stimulated. Cox regression analysis demonstrated that age, N stage, radiotherapy and the risk score were independent prognostic risk factors of BC, and a nomogram was established based on these variables. The nomogram exerted a favorable concordance index (0.798) as well as calibration performance, which strongly supports the clinical application of the nomogram. Our study indicated the disruption of the expression of CCRGs in BC and built a favorable prognostic risk model based on 3 independent prognostic CCRGs. These genes may be applied as candidate molecular targets for the diagnosis and therapy of BC.
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