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Abstract
Background Breast cancer was associated with imbalance between oxidation and antioxidation. Local oxidative stress in tumors is closely related to the occurrence and development of breast cancer. However, the relationship between systematic oxidative stress and breast cancer remains unclear. This study is aimed at exploring the prognostic value of systematic oxidative stress in patients with operable breast cancer. Methods A total of 1583 operable female breast cancer patients were randomly assigned into the training set and validation set. The relationship between systematic oxidative stress biomarkers and prognosis were analyzed in the training and validation sets. Results The systematic oxidative stress score (SOS) was established based on five systematic oxidative stress biomarkers including serum creatinine (CRE), serum albumin (ALB), total bilirubin (TBIL), lactate dehydrogenase (LDH), and blood urea nitrogen (BUN). SOS was an independent prognostic factor for operable breast cancer patients. A nomogram based on SOS and clinical characteristics could accurately predict the prognosis of operable breast cancer patients, and the area under the curve (AUC) of the nomogram was 0.823 in the training set and 0.872 in the validation set, which was much higher than the traditional prognostic indicators. Conclusions SOS is an independent prognostic indicator for operable breast cancer patients. A prediction model based on SOS could accurately predict the outcome of operable breast cancer patients.
Highlights
Breast cancer was associated with imbalance between oxidation and antioxidation
A total of 1583 female breast cancer patients were enrolled in this study, of whom 1187 (75%) patients were randomly assigned to the training set, and 396 (25%) patients were assigned to the validation set
In univariate Cox regression analysis, CRE, total bilirubin (TBIL), lactate dehydrogenase (LDH), uric acid (UA), blood urea nitrogen (BUN), ALB, and C-reactive protein (CRP) were correlated with the overall survival (OS) of breast cancer patients, while there is no statistical relationship between direct bilirubin (DBIL) and OS (Figure 1(a))
Summary
Local oxidative stress in tumors is closely related to the occurrence and development of breast cancer. This study is aimed at exploring the prognostic value of systematic oxidative stress in patients with operable breast cancer. A nomogram based on SOS and clinical characteristics could accurately predict the prognosis of operable breast cancer patients, and the area under the curve (AUC) of the nomogram was 0.823 in the training set and 0.872 in the validation set, which was much higher than the traditional prognostic indicators. The important role of local ROS in tumor tissue has been reported by many studies [8,9,10], but the relationship between systematic oxidative stress and prognosis of breast cancer patients is still unclear. In critically ill polytrauma patients, there were significant statistical differences in TBIL, serum albumin (ALB), LDH, and C-reactive protein (CRP) of patients
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