Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort Study
Background: China initiated its national free antiretroviral therapy program in 2004 and saw a dramatic decline in mortality among the population with HIV. However, the morbidity of non-AIDS-defining cancers such as breast cancer is steadily growing as life expectancy improves. The aim of this study...
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MDPI AG
2023-06-01
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| Online Access: | https://www.mdpi.com/1999-4915/15/7/1490 |
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| author | Qian Wu Li Deng Ye Cao Shixian Lian |
| author_facet | Qian Wu Li Deng Ye Cao Shixian Lian |
| author_sort | Qian Wu |
| collection | DOAJ |
| description | Background: China initiated its national free antiretroviral therapy program in 2004 and saw a dramatic decline in mortality among the population with HIV. However, the morbidity of non-AIDS-defining cancers such as breast cancer is steadily growing as life expectancy improves. The aim of this study was to investigate the clinical characteristics and prognosis of breast cancer patients with HIV in China. Materials and methods: Data from 21 breast cancer patients with HIV and 396 breast cancer patients without HIV treated at the Shanghai public health clinical center from 2014–2022 was collected. After propensity score matching, 21 paired patients in the two groups were obtained and compared. The optimal cut-off value of preoperative biomarkers for recurrence was determined via maximally selected log-rank statistics. Preoperative biomarkers were categorized into high and low groups, based on the best cut-off values and compared using Kaplan–Meier survival curves and the log-rank test. The Cox proportional hazards regression model was used to perform univariate and multivariate analyses. Results: The median follow-up time was 38 months (IQR: 20–68 months) for the propensity-score-matching cohort. The progression-free survival at 1, 2 and 3 years for patients with and without HIV were 74.51%, 67.74%, and 37.63% and 95.24%, 95.24%, and 90.48%, respectively. The overall survival for patients with HIV at 1, 2 and 3 years were 94.44%, 76.74%, and 42.63%. After multivariate analysis, Only HIV status (hazard ratios (HRs) = 6.83, 95% [confidence intervals (CI)] 1.22–38.12) were associated with progression-free survival. Based on the best cut-off value, CD8 showed discriminative value for overall survival (<i>p</i> = 0.04), whereas four variables, the lymphocyte-to-monocyte ratio (<i>p</i> = 0.02), platelet-to-lymphocyte ratio (<i>p</i> = 0.03), CD3 (<i>p</i> = 0.01) and CD8 (<i>p</i> < 0.01) were suggested be significant for progression-free survival. The univariate analysis suggested that CD3 (HRs = 0.10, 95% [CI] 0.01–0.90) and lymphocyte-to-monocyte ratio (HRs = 0.22, 95% [CI] 0.05–0.93) were identified as significant predictors for progression-free survival. Conclusion: In this study, breast cancer in patients with HIV in China reflected a more aggressive nature with a more advanced diagnostic stage and worse prognosis. Moreover, preoperative immune and inflammatory biomarkers might play a role in the prognosis of breast cancer patients with HIV. |
| first_indexed | 2024-03-11T00:34:36Z |
| format | Article |
| id | doaj.art-cacdf55e89ce43788ccd37ab3afefe97 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-11T00:34:36Z |
| publishDate | 2023-06-01 |
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| series | Viruses |
| spelling | doaj.art-cacdf55e89ce43788ccd37ab3afefe972023-11-18T21:44:26ZengMDPI AGViruses1999-49152023-06-01157149010.3390/v15071490Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort StudyQian Wu0Li Deng1Ye Cao2Shixian Lian3Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai 200040, ChinaDepartment of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, ChinaDepartment of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, ChinaDepartment of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, ChinaBackground: China initiated its national free antiretroviral therapy program in 2004 and saw a dramatic decline in mortality among the population with HIV. However, the morbidity of non-AIDS-defining cancers such as breast cancer is steadily growing as life expectancy improves. The aim of this study was to investigate the clinical characteristics and prognosis of breast cancer patients with HIV in China. Materials and methods: Data from 21 breast cancer patients with HIV and 396 breast cancer patients without HIV treated at the Shanghai public health clinical center from 2014–2022 was collected. After propensity score matching, 21 paired patients in the two groups were obtained and compared. The optimal cut-off value of preoperative biomarkers for recurrence was determined via maximally selected log-rank statistics. Preoperative biomarkers were categorized into high and low groups, based on the best cut-off values and compared using Kaplan–Meier survival curves and the log-rank test. The Cox proportional hazards regression model was used to perform univariate and multivariate analyses. Results: The median follow-up time was 38 months (IQR: 20–68 months) for the propensity-score-matching cohort. The progression-free survival at 1, 2 and 3 years for patients with and without HIV were 74.51%, 67.74%, and 37.63% and 95.24%, 95.24%, and 90.48%, respectively. The overall survival for patients with HIV at 1, 2 and 3 years were 94.44%, 76.74%, and 42.63%. After multivariate analysis, Only HIV status (hazard ratios (HRs) = 6.83, 95% [confidence intervals (CI)] 1.22–38.12) were associated with progression-free survival. Based on the best cut-off value, CD8 showed discriminative value for overall survival (<i>p</i> = 0.04), whereas four variables, the lymphocyte-to-monocyte ratio (<i>p</i> = 0.02), platelet-to-lymphocyte ratio (<i>p</i> = 0.03), CD3 (<i>p</i> = 0.01) and CD8 (<i>p</i> < 0.01) were suggested be significant for progression-free survival. The univariate analysis suggested that CD3 (HRs = 0.10, 95% [CI] 0.01–0.90) and lymphocyte-to-monocyte ratio (HRs = 0.22, 95% [CI] 0.05–0.93) were identified as significant predictors for progression-free survival. Conclusion: In this study, breast cancer in patients with HIV in China reflected a more aggressive nature with a more advanced diagnostic stage and worse prognosis. Moreover, preoperative immune and inflammatory biomarkers might play a role in the prognosis of breast cancer patients with HIV.https://www.mdpi.com/1999-4915/15/7/1490breast neoplasmsHIVprognosisbiomarkersCD3 |
| spellingShingle | Qian Wu Li Deng Ye Cao Shixian Lian Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort Study Viruses breast neoplasms HIV prognosis biomarkers CD3 |
| title | Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort Study |
| title_full | Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort Study |
| title_fullStr | Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort Study |
| title_full_unstemmed | Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort Study |
| title_short | Preoperative Biomarkers and Survival in Chinese Breast Cancer Patients with HIV: A Propensity-Score-Matched-Cohort Study |
| title_sort | preoperative biomarkers and survival in chinese breast cancer patients with hiv a propensity score matched cohort study |
| topic | breast neoplasms HIV prognosis biomarkers CD3 |
| url | https://www.mdpi.com/1999-4915/15/7/1490 |
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