摘要
目的:探讨血清人附睾蛋白4(HE4)、血管内皮生长因子(VEGF)、单核细胞趋化因子-1(MCP-1)及CC趋化因子配体20(CCL20)与乳腺癌患者保乳术后局部复发的关系。方法:选择2015年7月~2018年7月期间本院收治的乳腺癌患者312例作为研究对象,均符合保乳术手术指征,成功实施乳腺癌保乳术,所有患者均随访3年。检测两组血清HE4、VEGF、MCP-1、CCL20水平情况,单因素及多因素Logistic回归分析影响术后局部复发的因素。使用受试者工作特征(ROC)曲线分析HE4、VEGF、MCP-1、CCL20水平单独及联合检测对保乳术后局部复发的预测价值。结果:随访过程中失访6例,剩余的306例患者根据随访结果,分为局部复发组27例、无局部复发组279例,局部复发率为8.82%。局部复发组的血清HE4、VEGF、MCP-1、CCL20水平均高于无局部复发组(P<0.05)。单因素分析结果显示,乳腺癌患者保乳术后局部复发与年龄、淋巴结转移、切缘状态、人表皮生长因子受体2(Her-2)、细胞增殖相关抗原(Ki-67)、术后规范化疗、术后足程放疗有关(P<0.05)。多因素Logistic回归分析结果显示术后规范化疗、年龄偏高、术后足程放疗是保乳术后局部复发的保护因素,HE4、VEGF、MCP-1、CCL20水平偏高,切缘状态、Her-2、Ki-67阳性以及淋巴结转移是保乳术后局部复发的危险因素(P<0.05)。HE4、VEGF、MCP-1、CCL20联合应用预测乳腺癌患者保乳术后局部复发的效能高于单一指标应用。结论:乳腺癌保乳术后局部复发患者体内HE4、VEGF、MCP-1、CCL20水平高表达,四指标联合检测可辅助预测保乳术后局部复发。且乳腺癌患者保乳术后复发还受到切缘状态、Her-2、Ki-67等多种因素的影响。
Objective:To investigate the relationship between serum epididymal protein 4(HE4),vascular endothelial growth factor(VEGF),monocyte chemoattractant factor-1(MCP-1)and CC chemokine ligand 20(CCL20)and local recurrence after breast conserving surgery in breast cancer patients.Methods:312 cases of breast cancer who were admitted in our hospital from July 2015 to July 2018 were selected as the research objects,all of them were in conformity with the indications of breast conserving surgery.Breast conserving surgery was successfully carried out.All patients were followed up for 3 years.The serum HE4,VEGF,MCP-1 and CCL20levels in the two groups were detected,and the factors affecting postoperative local recurrence were analyzed by univariate and multivariate Logistic regression.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of HE4,VEGF,MCP-1 and CCL20 levels alone and in combination for local recurrence after breast conserving surgery.Results:During the follow-up,6 cases were lost.According to the follow-up results,the remaining 306 patients were divided into 27 cases in the local recurrence group and 279 cases in the non local recurrence group.The local recurrence rate was 8.82%.The serum HE4,VEGF,MCP-1and CCL20 levels in the local recurrence group were higher than those in the non local recurrence group(P<0.05).Univariate analysis showed that the local recurrence of breast cancer patients after breast conserving surgery was related to age,lymph node metastasis,cutting edge status,human epidermal growth factor receptor 2(Her-2),cell proliferation associated antigen(Ki-67),postoperative standardized chemotherapy and postoperative full range radiotherapy(P<0.05).Multivariate Logistic regression analysis showed that the postoperative standardized chemotherapy,high age,postoperative full range radiotherapy were the protective factors for local recurrence of breast cancer patients after breast conserving surgery,and the HE4,VEGF,MCP-1 and CCL20 levels were high,the cutting edge status,Her-2,Ki-67 positive and lymph node metastasis were the risk factors for local recurrence of breast cancer patients after breast conserving surgery,(P<0.05).The efficacy of HE4,VEGF,MCP-1 and CCL20 in predicting local recurrence after breast conserving surgery in breast cancer patients was higher than that of single index.Conclusion:The HE4,VEGF,MCP-1 and CCL20 levels are highly expressed in patients with local recurrence after breast conserving surgery for breast cancer.The combined detection of the four indexes can help predict the local recurrence of breast cancer patients after breast conserving surgery.Moreover,the recurrence of breast cancer patients after breast conserving surgery is also affected by many factors,such as the status of the cutting edge status,Her-2,Ki-67,etc.
作者
罗洁
刘世伟
张蒲蓉
张剑辉
牟鳄贤
夏莉
冉冉
张欣
徐佳
LUO Jie;LIU Shi-wei;ZHANG Pu-rong;ZHANG Jian-hui;MOU E-xian;XIA Li;RAN Ran;ZHANG Xin;XU Jia(Breast Surgery Center,Affiliated Cancer Hospital of Medical College of Universiy o1 Electronic Science and Technology Sichuan Cancer Hospital,Chengdu,Sichuan,610041,China)
出处
《现代生物医学进展》
CAS
2022年第14期2778-2783,共6页
Progress in Modern Biomedicine
基金
四川省科技计划项目(2020YJ0180)。
