Potential Values In Response Evaluation And Assessing Prognosis Of Detection Of Serum Ferritin For Breast Cancer With Neoadjuvant Chemotherapy

Objective To discuss the clinical value of the serum ferritin levels in predicting chemotherapeutic response and prognosis for 150 patients with breast cancer treated by neoadjuvant chemotherapy.Method (1) To detect the serum ferritin levels of 60 patients with benign breast diseases prio treatment and that of 150 patients with breast cancer before neoadjuvant chemotherapy, before and after chemotherapeutic every cycle, preoperative and 21 days after operation by using radioimmunoassay; and to evaluate the effectiveness by the MRI after every 2 cycles of neoadjuvant chemotherapy for the paitients with breast cancer. (2) To draw the scatter diagram,and then remove the influential observations and the high leverage cases. To compare the levels of the serum ferritin between the 60 patients with benign breast diseases prio treatment and 60 patients with breast cancer before chemotherapy by random sampling, then to determine the best value of the serum ferritin level by drawing the ROC curve for assisting the diagnosis of breast cancer. (3) To describe the median of the serum ferritin levels of paitients with breast cancer in all stages, and to explain the correlation between the serum ferritin levels after neoadjuvant chemotherapy and the clinical response by logistic analysis of regression, drawing the ROC curve and to ensure that (a) the optimal value of the serum ferritin to evaluate the effectiveness of neoadjuvant chemotherapy for the paitients with breast cancer; (b) To make sure the best boundary value effectively of the change (ΔSF1) of the serum ferritin level and that of the MRI imaging evaluation after every 2 cycles of neoadjuvant chemotherapy for the paitients with breast cancer. (4) To explain the relationship by the Chi-square analysis between the change (ΔSF2) of the serum ferritin levels before and after operation and the recurrence or metastasis of the paitients with breast cancer after resection. The comparison of the median of the serum ferritin levels in other groups are analysed by rank-sum test.Results (1) The rage of the serum ferritin levels with the breast cancer before treatment is from 5 ng/ml to 552 ng/ml, with the median of 80 ng/ml; The best boundary value of the serum ferritin levels of the patients with mammary disease is 73 ng/ml for assisting in diagnosis of breast cancer; (2) The later TNM of breast cancer, the higher of the serum ferritin level; the serum ferritin levels of the patients with breast cancer is correlated negatively with the effectiveness after neoadjuvant chemotherapy(p= 0.000, B=-0.004).The best boundary of value of the serum ferritin levels is 263 ng/ml for evaluation of neoadjuvant chemotherapy brings effective of the patients with breast cancer; The area under curve (AUC) of the ROC drawing by MRI evaluation after every 2 cycles of chemotherapy is 0.984±0.015,(p= 0.000,95% CI 0.954,1.015),with the image field range of values from 0.295 to 0.305; The AUC of the Δ SF1 of the patients with breast cancer after every 2 cycles of chemotherapy is 0.625 ±0.055,(p= 0.028,95% CI 0.517,0.732), and the optimal Δ SF1 is 133.5 ng/ml for effective evaluation; (3) The increasing of Δ SF2 of Postoperative patients is associated with recurrence (p= 0.032).Conclusion (1) SF levels of patients with breast cancer are significantly higher than normal and that of patients with breast benign disease; It is significant to diagnose breast cancer that the level of SF increase up to 73 ng/ml of the patient. (2) It has certain clinical value in effective evaluation by testing SF levels of the patients with breast cancer after neoadjuvant chemotherapy; It may be effective that level of SF reduce under 263 ng/ml after chemotherapy or the change of Δ SF1 under 133.5 ng/ml after every 2 cycles of chemotherapy, and the effectiveness is negatively correlated with the SF level;It is simple and low cost to evaluate response of chemotherapy by detecting serum ferritin levels for patients with breast cancer, but the accuracy of its is lower than MRI evaluation, and it is still important supplement as to evaluate response of chemotherapy. (3) It was better prognosis whom of the lower level of SF after operation; It may be an important auxiliary index to detect serum ferritin levels of patients with breast cancer for assessing the prognosis.