Objectives: The aim of the present study was to assess the clinical value of measuring the concentration of neurofilament light chains (NF-Ls) in the diagnosis of taxane-induced neuropathy (CIPN) during neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods: This study included a total of 94 patients who qualified for NAC with taxanes. Serum samples were collected before starting NAC, after three and six cycles, and 3–6 months after NAC. The NF-L concentration was determined using the Ella technology. The assessment of CIPN was based on the clinical symptoms included in the EORTC QLQ-CIPN20 scores. Results: The median NF-L concentrations increased during NAT monitoring. After the end of therapy, a significant decrease in NF-L concentrations was observed (p= 0.001, R = 0.37). We established a cut-off point of 29.5 pg/mL to distinguish between the control group and patients with early symptoms of neuropathy (CIPN G1) (p= 0.001; AUC = 0.982). We showed that NF-L concentrations, regardless of the stage of therapy, increased with the severity of neuropathy symptoms (CIPG1 vs. G2 vs. G3) (p= 0.0189, R = 0.33). According to the established cut-off points, serum NF-L concentrations above 196 pg/mL in patients undergoing therapy likely indicate the presence of low-grade neuropathy (p= 0.0076), while values above 218 pg/mL may indicate advanced CIPN (p= 0.0008). Conclusions: In this study, we demonstrated the usefulness of NF-L levels to confirm neuropathy early in the course of treatment, which is important as the questionnaire-based assessment of neuropathy currently used in practice remains subjective. Ultimately, serum NF-L levels are helpful in determining the severity of NAC-induced neuropathy among breast cancer patients.
目的：本研究旨在评估测量神经丝轻链（NF-L）浓度对乳腺癌患者新辅助化疗（NAC）期间紫杉类药物诱发周围神经病变（CIPN）诊断的临床价值。方法：本研究共纳入94例符合紫杉类NAC治疗条件的患者。分别于NAC开始前、第三和第六周期后以及NAC结束后3-6个月采集血清样本。采用Ella技术测定NF-L浓度。CIPN评估基于EORTC QLQ-CIPN20量表中包含的临床症状评分。结果：NAC监测期间NF-L浓度中位数持续升高。治疗结束后观察到NF-L浓度显著下降（p=0.001，R=0.37）。我们确定29.5 pg/mL为区分对照组与早期神经病变症状患者（CIPN G1）的临界值（p=0.001；AUC=0.982）。研究发现无论治疗处于何阶段，NF-L浓度均随神经病变症状严重程度（CIPN G1 vs. G2 vs. G3）增加而升高（p=0.0189，R=0.33）。根据既定临界值，治疗期间患者血清NF-L浓度高于196 pg/mL可能提示存在轻度神经病变（p=0.0076），而高于218 pg/mL则可能提示进展期CIPN（p=0.0008）。结论：本研究证实NF-L水平可用于早期确认治疗过程中的神经病变，这对当前临床实践中基于问卷的主观评估方式具有重要意义。最终，血清NF-L水平有助于确定乳腺癌患者NAC诱发神经病变的严重程度。
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