Analysis Of Clinical Features Affecting Abnormal Blood Glucose During Breast Cancer Chemotherapy

Background:Breast cancer is the most usual of all malignant diseases in the woman population and is the fifth reason cause of death from malignant tumors.More than10% of newly diagnosed malignant tumors are breast cancer every year.The incidence is second only to lung cancer,and it is increasing year by year,which has caused great harm to the health of the majority of women.Currently in clinical practice,the main treatment strategies for breast cancer include surgical treatment of local lesions in the body and systemic radiotherapy and chemotherapy,endocrine therapy,biological therapy,targeted therapy and the combination of the above treatments.Wait.Among all the treatment methods,chemotherapy plays an important role in the treatment of breast cancer,because most breast cancer patients must be treated with anti-tumor drugs,and the prevention and intervention of toxic and side effects caused by anti-tumor drugs,but also requires more attention.Scientific research has shown that the clinical pathological reasons,the selection of chemotherapy drugs and the application of chemotherapy adjuvant drugs can all lead to the fluctuation of blood sugar in breast cancer patients during chemotherapy,which can induce or aggravate diabetes mellitus,and the abnormal glucose metabolism of breast cancer patients may cause tumor microenvironment.Changes in breast cancer promote the metastasis of tumor cells,thereby reducing the survival rate of breast cancer patients.Other literature reports that chemotherapy-related hyperglycemia events can reduce the efficacy of chemotherapy drugs and increase chemotherapy toxicity.Studying the clinical features that affect blood glucose abnormalities during breast cancer chemotherapy can help clinicians make more rational treatment decisions.Objective:To explore the changes of blood glucose levels in patients with breast cancer during chemotherapy,analyze the clinical characteristics affecting blood glucose abnormalities,including clinicopathological factors,chemotherapy regimens and chemotherapy adjuvant drugs,and explore their possible mechanisms of action for better clinical decision-making and follow-up research provide a theoretical basis..Methods:A total of 219 breast cancer patients in the Breast Surgery Department of the Second Hospital of Jilin University from September 2019 to December 2021 were retrospectively collected,and these patients were recorded before each cycle of chemotherapy,3,7 days after chemotherapy and at the end of chemotherapy.The fasting blood glucose test indicators were reviewed in the next 3 months,and clinical relevant data（including age,menstruation,molecular typing,pathological staging,lymph node metastasis,chemotherapy regimen,and use of chemotherapy adjuvant drugs）were collected.And use SPSS26.0 software to process the data,and choose the chi-square test univariate analysis method to study the correlation between a single clinical feature and blood glucose variation;using binary logistic regression analysis method,can explore the process of chemotherapy.Independent risk factors for variability in blood glucose levels.P<0.05 was statistically significant.Results:1.A total of 219 patients were finally enrolled in the study,of which 158（72.1%）had abnormal blood glucose during chemotherapy,and 40（18.3%）had persistent abnormal blood glucose after chemotherapy.2.The results of single factor analysis to explore the clinical characteristics of dysglycemia during chemotherapy showed that during chemotherapy,molecular type,pathological stage,lymph node metastasis,chemotherapy cycle length,chemotherapy regimen strength and whether hormones were used or not affected its changes.factor（P<0.05）;further regression analysis of multiple factors showed:molecular type（OR=2.407,95%CI=1.341-4.321）,lymph node metastasis（OR=2.403,95%CI=1.312-4.401）and The use of hormones（OR=3.449,95%CI=1.505-7.903）was an independent risk factor（P<0.05）.3.The results of single factor analysis to explore the clinical characteristics of blood glucose variation after chemotherapy showed that molecular type,pathological stage,lymph node metastasis and whether hormones were used were the factors affecting its changes（P<0.05）.The results of factor regression analysis showed:pathological stage（OR=3.372,95%CI=1.597-7.120）,lymph node metastasis（OR=2.192,95%CI=1.273-3.776）and hormone use（OR=6.221,95%CI）=1.709-22.650)was its independent risk factor（P<0.05）.Conclusion:1.During chemotherapy of breast cancer patients,most of the patients will have abnormally elevated blood sugar,but the proportion of patients with persistent abnormal blood sugar after chemotherapy is low.2.Patients with positive HER-2,≥4 lymph node metastases,stage III pathological stage,strong chemotherapy regimen,6 cycles of chemotherapy,and long-term use of hormones are more likely to have abnormally elevated blood sugar during chemotherapy.3.Whether the blood glucose level is still abnormal in breast cancer patients after chemotherapy is also related to the clinicopathological conditions of the patients,that is,molecular type,pathological stage,number of lymph node metastases and whether hormones are used.