摘要
目的:探讨术前糖类抗原125(CA125)、骨桥蛋白(OPN)、趋化因子配体8(CXCL8)、中性粒细胞与淋巴细胞比值(NLR)联合检测对乳腺癌改良根治术患者术后复发转移风险的评估价值。方法:选取2015年4月-2016年4月期间我院收治的乳腺癌改良根治术患者384例按照术后有无复发转移分为未复发转移组(n=345)和复发转移组(n=39),对比复发转移组、未复发转移组CA125、OPN、CXCL8、NLR,乳腺癌改良根治术患者术后复发转移的影响因素采用多因素Logistic回归分析。采用受试者工作特征(ROC)曲线来判断CA125、OPN、CXCL8、NLR检测对乳腺癌改良根治术患者术后复发转移风险的评估价值。结果:复发转移组的CA125.OPN、CXCL8、NLR高于未复发转移组,组间对比差异有统计学意义(P<0.05)。乳腺癌改良根治术患者术后复发转移与肿瘤最大直径、临床分期、术前新辅助化疗、人表皮生长因子受体2(HER2)、淋巴结转移、组织学类型、细胞增殖标志抗原(ki-67)、雌激素受体(ER)/孕激素受体(PR)、P53、术后放疗、术后内分泌治疗有关(P<0.05)。多因素Logistic回归分析结果显示:OPN偏高、CXCL8偏高、NLR偏高、肿瘤最大直径≥2cm、淋巴结转移阳性、ER/PR双阴性临床分期为Ⅲ期、术前未接受新辅助化疗是乳腺癌改良根治术患者术后复发转移的危险因素(P<0.05)。术前CA125、OPN.CXCL8、NLR联合检测评估复发转移的曲线下面积(AUC)为0.855均高于各指标单独检测。结论:乳腺癌改良根治术后复发转移与OPN、CXCL8、NLR、肿瘤最大直径、淋巴结转移、ER/PR、临床分期、术前接受新辅助化疗均存在一定联系,临床需据此采取针对性干预措施加以防范。且术前CA125、OPN、CXCL8、NLR联合检测辅助评估术后复发转移的价值较高。
Objective:To evaluate the value of preoperative detection of carbohydrate antigen 125(CA125),osteopontin(OPN),chemokine ligand 8(CXCL8) and neutrophil lymphocyte ratio(NLR) in evaluating recurrence and metastasis risk of breast cancer patients undergoing modified radical mastectomy.Methods:384 patients with modified radical mastectomy whow ere treated in our hospital from April 2015 to April 2016 were divided into non recurrent metastasis group(n=345) and recurrent metastasis group(n=39)according to postoperative recurrence and metastasis.Compared with CA125,OPN,CXCL8 and NLR in relapse metastasis group and non recurrence metastasis group,multivariate regression analysis was used to analyze the influencing factors of recurrence and metastasis after modified radical mastectomy.The receiver operating characteristic(ROC) curve was used to determine the value of CA125,OPN,CXCL8 and NLR in evaluating the recurrence and metastasis risk of breast cancer patients undergoing modified radical mastectomy.Results:The levels of CA125,OPN,CXCL8 and NLR in recurrence and metastasis group were higher than those in non recurrence and metastasis group(P<0.05).Postoperative recurrence and metastasis of modified radical mastectomy were related to tumor diameter,clinical stage,preoperative neoadjuvant chemotherapy,human epidermal growth factor receptor 2(HER2),lymph node metastasis,histological type,cell proliferation marker antigen(Ki-67),estrogen receptor(ER)/progesterone receptor(PR),P53,postoperative radiotherapy,postoperative endocrine therapy(P<0.05).Multivariate Logistic regression analysis showed that OPN was high,CXCL8 was high,NLR was high,tumor diameter was greater than 2 cm,lymph node metastasis was positive,ER/PR was double negative,clinical stage was Ⅲ stage,and preoperative neoadjuvant chemotherapy was not a risk factor for recurrence and metastasis of breast cancer after modified radical mastectomy(P<0.05).The area under the curve(AUC) of preoperative CA125,OPN,CXCL8 and NLR was 0.855,which was higher than that of each index.Conclusion:The recurrence and metastasis of breast cancer after modified radical mastectomy are related to OPN,CXCL8,NLR,tumor diameter,lymph node metastasis,ER/PR,clinical stage and preoperative neoadjuvant chemotherapy.The combined detection of CA125,OPN,CXCL8 and NLR before operation is of high value in evaluating postoperative recurrence and metastasis.
作者
刘贺
张磊
曹恒
杜习成
蒋宏传
LIU He;ZHANG Lei;CAO Heng;DU Xi-cheng;JIANG Hong-chuan(Department of Breast Surgery,Beijing Chaoyang Hospital Afiliated to Capital Medical University,Beijing,100020,China)
出处
《现代生物医学进展》
CAS
2022年第9期1718-1723,共6页
Progress in Modern Biomedicine
基金
国家卫生计生委医药卫生科技发展项目(2018ZX09301005-001)。
