维生素D缺乏在诊断中对乳腺癌症生存率的负面影响：一项前瞻性队列研究

IF 1.9 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Breast Journal Pub Date : 2022-06-01 DOI:10.1155/2022/4625233

Benedito Souza Almeida-Filho, Michelle Sako Omodei, D. Buttros, E. Carvalho-Pessoa, Carla Priscila Carvalho-Pessoa, Heloisa De Luca Vespoli, E. Nahas

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The Kaplan–Meier curve and Cox regression model were used to assess the association between 25 (OH)D concentrations and survival rates. Differences in survival were evaluated by hazard ratios (HRs). Results. The mean age was 61.3 ± 9.6 years, 25 (OH)D concentration was 26.9 ± 7.5 ng/mL (range 12.0–59.2 ng/mL), and the follow-up period was between 54 and 78 months. Sufficient 25 (OH)D was detected in 33.9% of patients, insufficient in 47.9%, and deficient in 18.2%. A total of 51 patients (26.6%) died during the study period, with a mean OS time of 54.4 ± 20.2 months (range 9–78 months). Patients with 25 (OH)D deficiency and insufficiency at diagnosis had a significantly lower OS, DFS, and CSS compared with patients with sufficient values (\n \n p\n <\n 0\n .001\n \n ). 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引用次数: 0

摘要

客观的我们前瞻性评估了诊断时维生素D浓度与癌症绝经后妇女的总生存率（OS）、无病生存率（DFS）和癌症特异性生存率（CSS）之间的关系。方法。本研究包括192例新诊断为侵袭性癌症的患者，年龄≥45岁，诊断时血清25-羟基维生素D（25（OH）D）浓度评估。根据25（OH）D浓度将患者分组：充足（≥30 ng/mL），不足（介于20和29之间 ng/mL）和缺乏（<20 ng/mL）。主要结果为OS，次要结果为DFS和CSS。Kaplan–Meier曲线和Cox回归模型用于评估25（OH）D浓度与生存率之间的相关性。生存率的差异通过危险比（HR）进行评估。后果平均年龄61.3岁 ± 9.6年，25（OH）D浓度为26.9 ± 7.5 ng/mL（范围12.0–59.2 ng/mL），随访时间为54至78个月。在33.9%的患者中检测到充足的25（OH）D，47.9%检测到不足，18.2%检测到不足。在研究期间，共有51名患者（26.6%）死亡，平均OS时间为54.4 ± 20.2个月（范围为9-78个月）。25（OH）D缺乏和功能不全的患者在诊断时的OS、DFS和CSS显著低于具有足够值的患者（p＜0.001）。在调整了临床和肿瘤预后因素后，诊断时认为25（OH）D浓度不足的患者总体死亡风险显著更高（HR，4.65；95%CI，1.65-113.12），疾病复发风险更高（HR6.87；95%CI 2.35-2.18），与25（OH）D浓度足够的组相比，死于该疾病的风险更高（HR，5.91；95%CI，1.98-17.60）。结论在接受癌症治疗的绝经后妇女中，与25（OH）D浓度足够的患者相比，维生素D缺乏和诊断时维生素D不足与OS、DFS和CSS较低独立相关。

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Negative Impact of Vitamin D Deficiency at Diagnosis on Breast Cancer Survival: A Prospective Cohort Study

Objective. We prospectively evaluated the association between vitamin D concentration at diagnosis and overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) in postmenopausal women treated for breast cancer. Methods. This study included 192 patients newly diagnosed with invasive breast cancer, aged ≥45 years, and serum 25-hydroxy vitamin D (25 (OH)D) concentration assessment at diagnosis. Patients were classified into groups according to 25 (OH)D concentrations: sufficient (≥30 ng/mL), insufficient (between 20 and 29 ng/mL), and deficient (<20 ng/mL). The primary outcome was OS, and the secondary outcomes were DFS and CSS. The Kaplan–Meier curve and Cox regression model were used to assess the association between 25 (OH)D concentrations and survival rates. Differences in survival were evaluated by hazard ratios (HRs). Results. The mean age was 61.3 ± 9.6 years, 25 (OH)D concentration was 26.9 ± 7.5 ng/mL (range 12.0–59.2 ng/mL), and the follow-up period was between 54 and 78 months. Sufficient 25 (OH)D was detected in 33.9% of patients, insufficient in 47.9%, and deficient in 18.2%. A total of 51 patients (26.6%) died during the study period, with a mean OS time of 54.4 ± 20.2 months (range 9–78 months). Patients with 25 (OH)D deficiency and insufficiency at diagnosis had a significantly lower OS, DFS, and CSS compared with patients with sufficient values ( p < 0 .001 ). After adjustment for clinical and tumoral prognostic factors, patients with 25 (OH)D concentrations considered deficient at diagnosis had a significantly higher risk of global death (HR, 4.65; 95% CI, 1.65–13.12), higher risk of disease recurrence (HR, 6.87; 95% CI, 2.35–21.18), and higher risk of death from the disease (HR, 5.91; 95% CI, 1.98–17.60) than the group with sufficient 25(OH)D concentrations. Conclusion. In postmenopausal women treated for breast cancer, vitamin D deficiency and insufficiency at diagnosis were independently associated with lower OS, DFS, and CSS compared with patients with sufficient 25(OH)D concentrations.

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来源期刊

Breast Journal 医学-妇产科学

CiteScore

4.00

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.