Abstract：Objective To analyze the influencing factors of abnormal liver function after neoadjuvant chemotherapy in triple negative breast cancer (TNBC). Methods A total of 194 TNBC patients received neoadjuvant chemotherapy in Taihe Hospital, Shiyan, Hubei Province from June 2019 to June 2022 were selected and divided into study group (86 cases) and control group (108 cases) according to whether they had abnormal liver function after neoadjuvant chemotherapy. The clinical relevant indicators of the two groups were compared. Logistic regression model was used to analyze the influencing factors of abnormal liver function in TNBC patients after neoadjuvant chemotherapy. Results The incidence of abnormal liver function in 194 patients was 44.3% (86/194). The age, body mass index (BMI), proportion of menopausal patients, proportion of fatty liver patients, proportion of diabetes mellitus patients, proportion of TAC patients, and proportion of hepatitis B surface antigen positive patients in the study group were higher than those in the control group, and the differences were statistically significant (P＜0.05). The results of multivariate analysis showed that BMI (OR=1.494, 95%CI: 1.043-2.246), diabetes mellitus(OR=2.983, 95%CI: 1.619-5.547), fatty liver (OR=1.468, 95%CI: 1.011-2.129), TAC chemotherapy regimen (OR=5.574, 95%CI: 2.817-9.997), and hepatitis B surface antigen positive (OR=2.724, 95%CI: 1.134-5.581) were the influencing factors of abnormal liver function after neoadjuvant chemotherapy in TNBC patients (P＜0.05). Conclusion Various factors can lead to abnormal liver function in TNBC patients after neoadjuvant chemotherapy. Physical intervention should be taken to reduce the incidence of abnormal liver function and ensure the smooth progress of treatment.
艾勇彪 黄军 章书铭 李文仿. 三阴性乳腺癌新辅助化疗后肝功能异常的影响因素分析[J]. 中国医药导报, 2023, 20(26): 126-129.
AI Yongbiao HUANG Jun ZHANG Shuming LI Wenfang. Analysis of influencing factors of abnormal liver function after neoadjuvant chemotherapy for triple negative breast cancer. 中国医药导报, 2023, 20(26): 126-129.
[1] Wang X，Wang SS，Huang H，et al. Effect of Capecitabine Mai- ntenance Therapy Using Lower Dosage and Higher Frequency vs Observation on Disease-Free Survival Among Patients With Early-Stage Triple-Negative Breast Cancer Who Had Received Standard Treatment：The SYSUCC-001 Randomized Clinical Trial [J]. JAMA，2021，325（1）：50-58.
[2] 康一坤，袁芃.三阴性乳腺癌的治疗进展[J].肿瘤防治研究，2022，49（8）：812-819.
[3] Loibl S，Schneeweiss A，Huober J，et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response [J]. Ann Oncol，2022，33（11）：1149-1158.
[4] 夏林玉，胡清林.乳腺癌化疗性肝损伤相关危险因素的研究[J].肿瘤药学，2019，9（6）：919-923.
[5] Mahmoudvand S，Shokri S，Mirzaei H，et al. Frequency of Hepatitis B Virus infection among Patients before Chemot- herapy Treatment [J]. Asian Pac J Cancer Prev，2021，22（9）： 2939-2944.
[6] 中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范（2019年版）[J].中国癌症杂志，2019，29（8）：609-680.
[7] 张振香，何福培，张春慧，等.慢性病共病患者服药依从性潜在类别及其影响因素分析[J].中国全科医学，2022， 25（31）：3904-3913.
[8] 中国营养学会肥胖防控分会，中国营养学会临床营养分会，中华预防医学会行为健康分会，等.中国居民肥胖防治专家共识[J].西安交通大学学报（医学版），2022，43（4）： 619-631.
[9] Sakach E，O’Regan R，Meisel J，et al. Molecular Classification of Triple Negative Breast Cancer and the Emergence of Targeted Therapies [J]. Clin Breast Cancer，2021，21（6）：509- 520.
[10] Howard FM，Olopade OI. Epidemiology of Triple-Negative Breast Cancer：A Review [J]. Cancer J，2021，27（1）：8-16.
[11] 艾勇彪，李萌，张丹峰，等.青老年三阴性乳腺癌临床病理特征与预后对比分析[J].湖北医药学院学报，2019， 38（4）：364-368.
[12] 马珊珊，范静婧，王一凡，等.三阴性乳腺癌预后因素分析及预测模型构建[J].中华肿瘤防治杂志，2022，29（15）： 1099-1105.
[13] Beyerlin K，Jimenez R，Zangardi M，et al. The adjuvant use of capecitabine for residual disease following pre-operative chemotherapy for breast cancer：Challenges applying CREATE-X to a US population [J]. J Oncol Pharm Pract，2021， 27（8）：1883-1890.
[14] Meyer C，Bailleux C，Chamorey E，et al. Factors Involved in Delaying Initiation of Adjuvant Chemotherapy After Breast Cancer Surgery [J]. Clin Breast Cancer，2022，22（2）：121- 126.
[15] Ashok Kumar P，Paulraj S，Wang D，et al. Associated factors and outcomes of delaying adjuvant chemotherapy in breast cancer by biologic subtypes：a National Cancer Data- base study [J]. J Cancer Res Clin Oncol，2021，147（8）：2447- 2458.
[16] Hassan A，Fontana RJ. The diagnosis and management of idiosyncratic drug-induced liver injury [J]. Liver Int，2019， 39（1）：31-41.
[17] Moezian GSA，Javadinia SA，Sales SS，et al. Oral silymarin formulation efficacy in management of AC-T protocol induced hepatotoxicity in breast cancer patients：A randomized，triple blind，placebo-controlled clinical trial [J]. J Oncol Pharm Pract，2022，28（4）：827-835.
[18] 董冰，马保金，殷晓星.HBV感染的乳腺癌患者化疗后HBV血清学标志物及肝功能变化分析[J].中华医院感染学杂志，2019，29（6）：864-867.
[19] Xiao W，Zhou Y，Yu P，et al. Prognostic value of chronic hepatitis B virus infection in patients with breast cancer in a hepatitis B virus endemic area [J]. Ann Transl Med，2020，8（5）：180.
[20] Liu Z，Jiang L，Liang G，et al. Hepatitis B virus reactivation in breast cancer patients undergoing chemotherapy：A review and meta-analysis of prophylaxis management [J]. J Viral Hepat，2017，24（7）：561-572.
[21] Chen CH，Hsieh HH，Wu TY. Real-world prevalence of hepatitis B virus reactivation in cancer patients in Taiwan [J]. J Oncol Pharm Pract，2021，27（1）：63-70.
[22] 夏林玉，徐卫云.乳腺癌化疗相关性肝损伤的研究进展[J].西部医学，2017，29（5）：737-740.
[23] Loomba R，Friedman SL，Shulman GI. Mechanisms and disease consequences of nonalcoholic fatty liver disease [J]. Cell，2021，184（10）：2537-2564.
[24] Desmedt C，Fornili M，Clatot F，et al. Differential Benefit of Adjuvant Docetaxel-Based Chemotherapy in Patients with Early Breast Cancer According to Baseline Body Mass Index [J]. J Clin Oncol，2020，38（25）：2883-2891.
[25] Stefan N，Cusi K. A global view of the interplay between non- alcoholic fatty liver disease and diabetes [J]. Lancet Diabetes Endocrinol，2022，10（4）：284-296.
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