A Study On The Prediction Index Of Individual Risk Of Chemotherapy-induced Nausea And Vomiting Through The Analysis Of Metabonomics Data Of Breast Cancer Patients

Objective To investigate the correlation between baseline levels of serum amino acids in breast cancer patients and acute nausea and vomiting caused by chemotherapy,and to explore the feasibility of baseline serum amino acid levels before chemotherapy as an acute CINV risk predictors in breast cancer patients.Methods From August 2017 to August 2019,A total of sixty-seven breast cancer patients hospitalized in the first affiliated hospital of Jinzhou Medical University were included in the study The data including age,the course of nausea or vomiting recorded within 24 hours after initiation of the first chemotherapy infusion,the serum amino acid detection value of the patient in the fasting state in the morning of chemtherapy.Chemotherapy regimes used by the patients were all medium-to-high emetic regimens,before the surgery they did not receive radiotherapy,chemotherapy or other treatment and it was their first time to receive postoperative adjuvant chemotherapy.On the basis of the specific situation of acute nausea or vomiting during the chemotherapy cycle recorded in the electronic medical record system,the CINV was divided into five grades from 0 to IV grade by using the WHO grading criteriathe.In order to verifywhether the correlation between amino acids and CINV was significant,SAS_JMP software 11 was used to analyze the correlation between serum amino acid detection values and CINV grade before chemotherapy using spelman correlation coefficient,and the correlation coefficient value range was-1<ρ<1.With P<0.05 as the difference was statistically significant,the related amino acid species were further constructed CINV risk prediction model,the ROC curve was drawn,and the sensitivity and specificity of the model were evaluated.Results The total incidence of CINV in this study was 53.7%,and the median age of grade 0 and I CINV were 55 and 54.5,respectively.Spelman correlation coefficient showed that the detection values of glutamate,glycine and citrulline were negatively correlated with acute CINV(glutamate:χ~2=-0.3141,P=0.0096.glycine:χ~2=-0.2992,P=0.0139.citrulline: χ~2=-0.2426,P=0.0479).Serum glutamate,serum glycine and serum citrulline were used to predict the risk of acute CINV in breast cancer patients based on the results of spelman grade correlation coefficient analysis,and the ROC curve was drawn to evaluate the sensitivity and specificity of the diagnostic model.compared with glycine and citrulline,the glutamate model was better,with sensitivity of52.17%,specificity of 66.67% and AUC of 0.70053.Conclusions Serum glutamate,serum glycine and serum citrulline before chemotherapy may be used as predictors of acute CINV risk in breast cancer patients.