2025 年第 8 期 第 20 卷

代谢综合征联合炎症指数对三阴性乳腺癌预后的预测价值

The predictive value of metabolic syndrome combined with inflammation index for the prognosis of triple-negative breast cancer

作者：牛梦晔1高先2张宏旭3

英文作者：Niu Mengye1 Gao Xian2 Zhang Hongxu3

单位：1首都医科大学附属北京安贞医院普外科，北京100029；2河北医科大学第一医院甲状腺乳腺疝外科，石家庄050000；3承德医学院附属医院乳腺外科，承德067000

英文单位：1Department of General Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Thyroid and Mammary Hernia Surgery The First Hospital of Hebei Medical University Shijiazhuang 050000 China; 3Department of Breast Surgery Affiliated Hospital of Chengde Medical University Chengde 067000 China

关键词：三阴性乳腺癌；代谢综合征；炎症指数；联合预测

英文关键词：Triple-negativebreastcancer;Metabolicsyndrome;Inflammatoryindex;Jointprediction

• 摘要：

• 目的 探讨联合代谢综合征(MS)、全身炎症指数(SIRI)及纤维蛋白原/清蛋白比值(FAR)对三阴性乳腺癌(TNBC)预后的预测价值，构建评分系统并验证其对TNBC预后的预测价值。方法 选取2019年1—12月于承德医学院附属医院和河北医科大学第一医院就诊的252例TNBC患者为训练集，另选取2020年1—4月于两所医院就诊的98例TNBC患者为验证集。训练集中伴有MS的48例患者纳入观察组，不伴有MS的204例患者纳入对照组。随访3年记录其不良事件的发生情况。构建MS、FAR、SIRI评分系统并评价其预测效能。结果  训练集和验证集患者基线资料比较，差异均无统计学意义（均P＞0.05）。观察组和对照组患者收缩压、舒张压、体重指数、甘油三酯、高密度脂蛋白、血糖水平和糖尿病、高血压病、不良结局比例比较，差异均有统计学意义（均P＜0.001）。单因素Cox回归分析结果显示SIRI和MS均为TNBC患者不良结局的危险因素，FAR是TNBC患者不良结局的保护因素（均P＜0.05）。受试者工作特征曲线分析结果显示，SIRI的曲线下面积为0.853，FAR的曲线下面积为0.787，评分系统的曲线下面积为0.886。结论  训练集构建预测模型验证发现MS、FAR、SIRI均是TNBC不良预后的独立预测因素，其构建的评分系统提高不良预后的预测效能。

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  Objective To explore the predictive value of combining metabolic syndrome (MS), systemic inflammation index (SIRI) and fibrinogen/albumin ratio (FAR) in the prognosis of triple-negative breast cancer (TNBC), construct a scoring system and verify its predictive value for the prognosis of TNBC. Methods A total of 252 TNBC patients treated in the Affiliated Hospital of Chengde Medical University and the First Hospital of Hebei Medical University from January to December 2019 were selected as the training set, and 98 TNBC patients treated in the two hospitals from January to April 2020 were selected as the validation set. In the training set, 48 patients with MS were included in the observation group, and 204 patients without MS were included in the control group. The patients were followed up for 3 years to record the occurrence of adverse events. MS, FAR and SIRI scoring systems were constructed and their predictive efficacy was evaluated. Results There were no significant differences in baseline data between the training set and the validation set (all P>0.05). There were statistically significant differences in the levels of systolic blood pressure, diastolic blood pressure, body mass index, triglyceride, high-density lipoprotein, blood glucose, and the proportions of diabetes, hypertension, and adverse outcomes between the observation group and the control group (all P<0.001). The results  of univariate Cox regression analysis showed that SIRI and MS were risk factors for the poor outcome of TNBC patients, and FAR was a protective factor for the poor outcome of TNBC patients (all P<0.05). Receiver operating characteristic curve analysis results  showed that the area under the curve of SIRI was 0.853, the area under the curve of FAR was 0.787, and the area under the curve of the scoring system was 0.886. Conclusion MS, FAR and SIRI are independent predictors of poor prognosis in TNBC, and the scoring system constructed by them can improve the prediction efficiency of poor prognosis.