PCR Correlation Analysis Between ApoB And Neoadjuvant Chemotherapy In Invasive Breast Cancer

Objective:As a simple,quick and readily available clinical indicator,the association between circulating serum lipids and breast cancer incidence and prognosis has been confirmed.PCR correlation analysis between Apo B and neoadjuvant chemotherapy in invasive breast cancer.In view of the lack of studies on lipid level as a clinical predictor of pathological complete response in patient with NAC,the purpose of this study was to combine clinicopathological features with serum lipids as a clinical predictor of pathological complete response after NAC,and provide reference for individual treatment decisions of breast cancer patients.Methods:A total of 133 consecutive cases of invasive breast cancer who received a complete course of neoadjuvant chemotherapy were enrolled in the department of Breast Surgery,Affiliated Hospital of Southwest Medical University from September 1,2018 to January 31,2021.A retrospective analysis was performed on their blood lipids,clinicopathological features and other clinical records before NAC.Serum lipids including total cholesterol(TC)、triglyceride(TG)、low density lipoprotein cholesterol(LDL-C)、high density lipoprotein cholesterol,(HDL-C)、apolipoprotein A-I(Apo A-I)and apolipoprotein B(Apo B).The cut-off value of quantitative variables such as age and blood lipid level was determined by the Yuden index of receiver Operating characteristic(ROC)curve,and the continuous variables were converted into dichotomous variables according to the cut-off value.X~2test was used for categorical variables and independent sample T test was used for quantitative variables.Single factor analysis was performed for the two groups of data in the first place.Indicators with P<0.05 and those with possible clinical significance were included in binary Logistic regression analysis.The influencing factors of post-NAC p CR were determined by binary logistic regression analysis,and the prediction model of post-NAC p CR was developed according to multivariate analysis results.The ROC curve of the model was drawn,and the area under curve(AUC)was calculated to evaluate the efficiency of the model.Results:Among 133 patients,32.3%(43/133)of them achieved p CR.Univariate analysis showed that molecular type(X~2=20.531,P<0.0001)、clinical stage(X~2=8.423,P=0.004)、TC(X~2=7.810,P=0.005)、TG(X~2=4.582,P=0.032)、LDL-C(X~2=4.197,P=0.041)、Apo A-I(X~2=4.246,P=0.039)、Apo B(X~2=4.987,P=0.026)were all related factors of p CR after NAC.Age(t=0.221,P=0.825),menopausal status(X~2=0.046,P=0.830),body mass index(BMI)(X~2=0.218,P=0.641),HDL-C(X~2=3.459,P=0.063)had no significant correlation with pathological complete response after NAC(P>0.05).Multivariate logistic analysis showed that molecular type(P=0.001)、clinical stage(P=0.002)、Apo B(P=0.03)were independent factors for post-NAC p CR.Molecular typing(1)(OR=3.736,95%CI:1.229-11.357)、molecular typing(2)(OR=12.209,95%CI:3.340-44.637)、molecular typing(3)(OR=1.206,95%CI:0.352-4.133)、stage(OR=0.214,95%CI:0.079-0.578)、Apo B(OR=2.607,95%CI:1.094-6.211).Based on this,a logistic regression prediction model was constructed logit(P)=0.958×Apo B level-1.543×clinical stage+0.188×molecular typing(3)+2.502×molecular typing(2)+1.318×molecular typing(1)-1.567(X2=35.178,P<0.001),in which molecular type(1)indicate HR+/HER2+type,molecular type(2)indicate HER2 overexpressed type,and molecular type(3)indicate TNBC subtype.The ROC curve of the model was drawn,and the area under curve was 0.788,indicating that the prediction model had good discriminative ability.Conclusion:In addition to clinical stage,molecular pathological features,serum Apo B levels are also an independent influencing factor of complete pathological remission after NAC.Clinical stage,molecular pathological features combined with Apo B can serve as a new predictor of complete pathological response after NAC,and in turn can guide individualized therapeutic strategies for patients.