Cunliang Wang1,2, Wei Han3, Yuanting Gu1. 1. Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 2. Medical Service, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 3. Quality Control Division, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Abstract
BACKGROUND: As one of the main malignant tumors affecting women, the incidence of breast cancer increases year by year. This study aims to analyze the risk factors of infection in breast cancer patients during postoperative chemotherapy by measuring the changes in the levels of T lymphocytes and inflammatory factors in peripheral blood. METHODS: The clinical data of 156 patients who underwent radical mastectomy and postoperative chemotherapy [docetaxel, epirubicin, cyclophosphamide (TEC)] in our hospital from May 2014 to April 2018 were retrospectively analyzed. According to the presence or absence of infection after chemotherapy, patients were divided into the infection group and the normal group. The risk factors of infection during chemotherapy were analyzed by univariate and multiple logistic regression analyses. Serum before surgery, and before and after chemotherapy, was collected to detect the levels of T lymphocytes and inflammatory factors. RESULTS: A total of 36 patients developed an infection during chemotherapy, with an infection rate of 23.08%. The main infection site was the respiratory tract. The main pathogens detected were Gram-negative bacteria and Gram-positive bacteria. The results of univariate analysis showed that there were significant differences in age, diabetes mellitus, clinical TNM staging, white blood cell count (WBC), T lymphocyte subsets CD4+/CD8+, C-reactive protein (CRP) levels, and tumor necrosis factor-α (TNF-α) levels between the 2 groups (P<0.05). Results of logistic regression analysis showed that age ≥60 years old, diabetes mellitus, clinical TNM staging ≥ stage III, WBC <3.5×109/L, CD4+/CD8+ <1.33, TNF-α ≥70 ng/L and CRP ≥60 mg/L were all independent risk factors of postoperative infection (P<0.05). Both before and after chemotherapy, levels of CD3+, CD3+CD4+ and CD4+/CD8+ cells in the infection group were significantly lower than those in the normal group, while levels of CRP, TNF-α and IL-6 were significantly higher than those in the normal group (P<0.05). CONCLUSIONS: Dynamic monitoring of changes in the levels of T lymphocytes and inflammatory factors during chemotherapy may be of clinical value for predicting the risk of infection. Implementing targeted intervention measures for these risk factors may therefore be beneficial for controlling infection. 2020 Gland Surgery. All rights reserved.
BACKGROUND: As one of the main malignant tumors affecting women, the incidence of breast cancer increases year by year. This study aims to analyze the risk factors of infection in breast cancer patients during postoperative chemotherapy by measuring the changes in the levels of T lymphocytes and inflammatory factors in peripheral blood. METHODS: The clinical data of 156 patients who underwent radical mastectomy and postoperative chemotherapy [docetaxel, epirubicin, cyclophosphamide (TEC)] in our hospital from May 2014 to April 2018 were retrospectively analyzed. According to the presence or absence of infection after chemotherapy, patients were divided into the infection group and the normal group. The risk factors of infection during chemotherapy were analyzed by univariate and multiple logistic regression analyses. Serum before surgery, and before and after chemotherapy, was collected to detect the levels of T lymphocytes and inflammatory factors. RESULTS: A total of 36 patients developed an infection during chemotherapy, with an infection rate of 23.08%. The main infection site was the respiratory tract. The main pathogens detected were Gram-negative bacteria and Gram-positive bacteria. The results of univariate analysis showed that there were significant differences in age, diabetes mellitus, clinical TNM staging, white blood cell count (WBC), T lymphocyte subsets CD4+/CD8+, C-reactive protein (CRP) levels, and tumor necrosis factor-α (TNF-α) levels between the 2 groups (P<0.05). Results of logistic regression analysis showed that age ≥60 years old, diabetes mellitus, clinical TNM staging ≥ stage III, WBC <3.5×109/L, CD4+/CD8+ <1.33, TNF-α ≥70 ng/L and CRP ≥60 mg/L were all independent risk factors of postoperative infection (P<0.05). Both before and after chemotherapy, levels of CD3+, CD3+CD4+ and CD4+/CD8+ cells in the infection group were significantly lower than those in the normal group, while levels of CRP, TNF-α and IL-6 were significantly higher than those in the normal group (P<0.05). CONCLUSIONS: Dynamic monitoring of changes in the levels of T lymphocytes and inflammatory factors during chemotherapy may be of clinical value for predicting the risk of infection. Implementing targeted intervention measures for these risk factors may therefore be beneficial for controlling infection. 2020 Gland Surgery. All rights reserved.
Entities:
Keywords:
Breast cancer; chemotherapy; infection; radical surgery
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