The Correlation Between Neutrophil-to-lymphocyte Ratio, Carcinoembryonic Antigen, and Carbohydrate Antigen 153 Levels with Chemotherapy-related Cognitive Impairment in Early-stage Breast Cancer Patients
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Background: Early detection and intervention are of great significance to the clinical management of cancer-related diseases. Peripheral blood biomarkers [e.g., neutrophil-to-lymphocyte ratio (NLR), carcinoembryonic antigen (CEA), and carbohydrate antigen 153 (CA153)] are obtained in real-timely, conveniently, and less invasively, and proved to availably predicted the disease states and prognosis of various cancers, including breast cancer (BC). Inflammation and poor disease management promote cognitive impairment. Chemotherapy-related cognitive impairment (CRCI) hazard long-term survival and quality of life (QOL) of BC patients, but its correlation with NLR, CEA, and CA153 is not clear.
Purpose: This study aimed to investigate changes in NLR, CEA, and CA153 levels before and after chemotherapy and their correlation with CRCI in patients with early-stage BC.
Materials And Methods: The 187 patients with BC who were measured for NLR, CEA, and CA153 values within the first 24 hours of admission, were assigned into two groups: the before/after chemotherapy group (BCG/ACG). The ACG was assigned into two subgroups based on the cognitive assessment results: the cognitive normal/impaired group (CNG/CIG). Patients' self-perceived cognitive impairments were evaluated using a mini-mental state examination (MMSE), prospective and retrospective memory (PM and RM) questionnaire (PRMQ), and functional assessment of cancer therapy-cognitive function version 3 (FACT-Cog, version 3, including CogPCI, CogOth, CogPCA, and CogQOL). Their QOL was also evaluated.
Results: The NLR and CA153 levels were elevated after chemotherapy (BCG vs ACG: = -1.996 and -1.615, = 0.046 and 0.106, respectively), and significantly elevated in patients with CRCI (BCG vs CIG: = -2.444 and -2.293, = 0.015 and 0.022; respectively). However, there was not reach significant difference in CEA levels between the four groups. In addition, there was a weak to moderate correlation between peripheral blood biomarkers (NLR, CEA, and CA153) levels and CRCI ( = -0.404, -0.205, -0.322; respectively; < 0.001). Cognitive impairment scores (MMSE, PM, RM, and FACT-Cog) had a strong correlation with QOL in patients with early-stage BC ( = -0.786, 0.851, 0.849, and 0.938; respectively; < 0.001).
Conclusion: NLR and CA153 m be valuable diagnostic adjuncts of CRCI, and CRCI has a strong correlation with QOL in patients with early-stage BC.
Jiang B, Wu S, Zeng L, Tang Y, Luo L, Ouyang L Cancer Cell Int. 2024; 24(1):99.
PMID: 38459583 PMC: 10921816. DOI: 10.1186/s12935-024-03244-1.