血清MMP-2、MMP-9和CA15-3水平在乳腺癌中的临床病理学意义及预后价值
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摘要
目的探究血清基质金属蛋白酶-2(matrix metalloprotein-2,MMP-2)、基质金属蛋白酶-9(matrix metallopro-tein-9,MMP-9)和CA15-3水平在乳腺癌中的临床病理学意义及预后评估中的临床价值。方法收集乳腺癌患者60例,同期选取健康体检者80例。采用t检验分析血清MMP-2、MMP-9和CA15-3在组间的差异。相关性分析采用Spearman检验。多项Logistic回归分析计算比值比(odds ratio,OR)及其95%置信区间(confidence interval,CI)。采用Kaplan-Meier法和对数秩检验(log-rank test)进行生存分析。结果与健康组相比,乳腺癌患者血清MMP-2、MMP-9和CA15-3水平均增高,且差异具有统计学意义(P <0. 05)。血清MMP-2、MMP-9和CA15-3水平与肿瘤的分子分型(与血清MMP-2、MMP-9和CA15-3的R2分别为0. 296、0. 285、0. 283,P <0. 001)、TNM分期(与血清MMP-2、MMP-9和CA15-3的R2分别为0. 310、0. 276、0. 303,P <0. 001)显著相关。多元Logistic回归多因素分析显示,在校正年龄、吸烟、饮酒、糖尿病等因素影响后,高MMP-2、高MMP-9和高CA15-3是乳腺癌的独立危险因素。生存分析显示,同低MMP-2组相比,高MMP-2组患者的生存时间显著降低(log-rank P=0. 026);同低MMP-9组相比,高MMP-9组患者的生存时间显著降低(log-rank P=0. 012);而CA15-3水平高低患者的生存时间差异无统计学意义(log-rank P=0. 563)。结论血清MMP-2和MMP-9在评估乳腺癌患者预后中具有的重要临床意义。
Objective To explore the clinic pathological significance and prognosis value of serum matrix metalloproteinase-2( MMP-2),matrix metalloproteinase-9( MMP-9) and CA15-3 levels in breast cancer. Methods A total of 60 breast cancer patients were enrolled in our hospital from January 2014 to January 2016,and 80 health controls were selected at the same time.The difference of serum MMP-2,MMP-9 and CA15-3 between patients and controls was analyzed by t test. Spearman test was used for the correlation analysis. Multiple logistic regression was used to analyses the odds ratio( OR) and its 95% confidence intervals( CIs) The Kaplan-Meier method and the logarithmic rank test( log-rank test) were used for the survival analysis. Results Compared with the health group,the levels of MMP-2,MMP-9 and CA15-3 in breast cancer patients were significantly higher( P <0. 05). Moreover,the levels of serum MMP-2,MMP-9 and CA15-3 were significantly related to the molecular typing of tumor( R2 were 0. 296,0. 285,0. 283,respectively,P < 0. 001) and TNM staging( R2 were 0. 310,0. 276,0. 303,respectively,P < 0. 001).The levels of serum MMP-2,MMP-9 and CA15-3 increased significantly in patients with basal-like breast cancer. Multivariate logistic regression analysis showed that high MMP-2,high MMP-9 and high CA15-3 were independent risk factors of breast cancer after adjusting for age,smoking,drinking,diabetes and CA125. Survival analysis showed that the survival time of patients in high MMP-2 group was significantly lower than that in low MMP-2 group( log-rank P = 0. 026),and the survival time of patients in high MMP-9 group was significantly lower than that in low MMP-9 group( log-rank P = 0. 012),but there was no significant difference in the survival time between high CA15-3 and low CA15-3 group( log-rank P = 0. 563). Conclusion Serum MMP-2 and MMP-9 have important clinical significance in evaluating the prognosis of patients with breast cancer.
Objective To explore the clinic pathological significance and prognosis value of serum matrix metalloproteinase-2( MMP-2),matrix metalloproteinase-9( MMP-9) and CA15-3 levels in breast cancer. Methods A total of 60 breast cancer patients were enrolled in our hospital from January 2014 to January 2016,and 80 health controls were selected at the same time.The difference of serum MMP-2,MMP-9 and CA15-3 between patients and controls was analyzed by t test. Spearman test was used for the correlation analysis. Multiple logistic regression was used to analyses the odds ratio( OR) and its 95% confidence intervals( CIs) The Kaplan-Meier method and the logarithmic rank test( log-rank test) were used for the survival analysis. Results Compared with the health group,the levels of MMP-2,MMP-9 and CA15-3 in breast cancer patients were significantly higher( P <0. 05). Moreover,the levels of serum MMP-2,MMP-9 and CA15-3 were significantly related to the molecular typing of tumor( R2 were 0. 296,0. 285,0. 283,respectively,P < 0. 001) and TNM staging( R2 were 0. 310,0. 276,0. 303,respectively,P < 0. 001).The levels of serum MMP-2,MMP-9 and CA15-3 increased significantly in patients with basal-like breast cancer. Multivariate logistic regression analysis showed that high MMP-2,high MMP-9 and high CA15-3 were independent risk factors of breast cancer after adjusting for age,smoking,drinking,diabetes and CA125. Survival analysis showed that the survival time of patients in high MMP-2 group was significantly lower than that in low MMP-2 group( log-rank P = 0. 026),and the survival time of patients in high MMP-9 group was significantly lower than that in low MMP-9 group( log-rank P = 0. 012),but there was no significant difference in the survival time between high CA15-3 and low CA15-3 group( log-rank P = 0. 563). Conclusion Serum MMP-2 and MMP-9 have important clinical significance in evaluating the prognosis of patients with breast cancer.
引文
[1]志柳,白洁,顾丽娜,等.2000~2010年我国前列腺癌和乳腺癌流行状况的系统性综述[J].中国肿瘤,2013,22(4):260-265.
[2]郑莹,吴春晓,张敏璐.乳腺癌在中国的流行状况和疾病特征[J].中国癌症杂志,2013,23(8):561-569.
[3]黄哲宙,陈万青,吴春晓,等.中国女性乳腺癌的发病和死亡现况-全国32个肿瘤登记点2003~2007年资料分析报告[J].肿瘤,2012,32(6):435-439.
[4]Chan OTM,Furuya H,Pagano I,et al.Association of MMP-2,RB and PAI-1 with decreased recurrence-free survival and overall survival in bladder cancer patients[J].Oncotarget,2017,8(59):99707-99721.
[5]Shi ZM,Liu YN,Fu B,et al.Expression profile of eukaryotic translation initiation factor and matrix metalloproteinase 9in endometrial cancer tissue[J].J Biol Regul Homeost A-gents,2017,31(4):1053-1059.
[6]周斌,季科,辛灵,等.美国肿瘤联合会乳腺癌分期系统(第8版)更新内容介绍及解读[J].中国实用外科杂志,2017,37(1):10-14.
[7]皮亚平,田柳.肿瘤标志物CA153、CA125联合检查对乳腺癌诊断的价值分析[J].实用癌症杂志,2017,32(8):1351-1353.
[8]师金,梁迪,李道娟,等.全球女性乳腺癌流行情况研究[J].中国肿瘤,2017,26(9):683-690.
[9]韩龙才,李玉柱,张华,等.超声、钼靶、MRI及肿瘤标志物联合检测在乳腺癌诊断中的价值研究[J].标记免疫分析与临床,2016,23(11):1314-1316.
[10]白韬,杜潇,卜君,等.乳腺超声光散射成像联合血清CA15-3、CEA检测在乳腺肿瘤中的诊断价值[J].标记免疫分析与临床,2017,24(7):762-765.
[11]Jiang XJ,Lin J,Cai QH,et al.CDH17 alters MMP-2 expression via canonical NF-κB signalling in human gastric cancer[J].Gene,2018,1119(18):30531-30536.
[12]Xu J,E C,Yao Y,et al.Matrix metalloproteinase expression and molecular interaction network analysis in gastric cancer[J].Oncol Lett,2016,12(4):2403-2408.
[13]Zhang Y,Zheng W,Shen K,et al.Δ9-tetrahydrocannabinol inhibits epithelial-mesenchymal transition and metastasis by targeting matrix metalloproteinase-9 in endometrial cancer[J].Oncol Lett,2018,15(6):8527-8535.
[14]Pietruszewska W,Bojanowska-Po7niak K,Kobos J.Matrix metalloproteinases MMP1,MMP2,MMP9 and their tissue inhibitors TIMP1,TIMP2,TIMP3 in head and neck cancer:an immunohistochemical study[J].Otolaryngol Pol,2016,70(3):32-43.
[2]郑莹,吴春晓,张敏璐.乳腺癌在中国的流行状况和疾病特征[J].中国癌症杂志,2013,23(8):561-569.
[3]黄哲宙,陈万青,吴春晓,等.中国女性乳腺癌的发病和死亡现况-全国32个肿瘤登记点2003~2007年资料分析报告[J].肿瘤,2012,32(6):435-439.
[4]Chan OTM,Furuya H,Pagano I,et al.Association of MMP-2,RB and PAI-1 with decreased recurrence-free survival and overall survival in bladder cancer patients[J].Oncotarget,2017,8(59):99707-99721.
[5]Shi ZM,Liu YN,Fu B,et al.Expression profile of eukaryotic translation initiation factor and matrix metalloproteinase 9in endometrial cancer tissue[J].J Biol Regul Homeost A-gents,2017,31(4):1053-1059.
[6]周斌,季科,辛灵,等.美国肿瘤联合会乳腺癌分期系统(第8版)更新内容介绍及解读[J].中国实用外科杂志,2017,37(1):10-14.
[7]皮亚平,田柳.肿瘤标志物CA153、CA125联合检查对乳腺癌诊断的价值分析[J].实用癌症杂志,2017,32(8):1351-1353.
[8]师金,梁迪,李道娟,等.全球女性乳腺癌流行情况研究[J].中国肿瘤,2017,26(9):683-690.
[9]韩龙才,李玉柱,张华,等.超声、钼靶、MRI及肿瘤标志物联合检测在乳腺癌诊断中的价值研究[J].标记免疫分析与临床,2016,23(11):1314-1316.
[10]白韬,杜潇,卜君,等.乳腺超声光散射成像联合血清CA15-3、CEA检测在乳腺肿瘤中的诊断价值[J].标记免疫分析与临床,2017,24(7):762-765.
[11]Jiang XJ,Lin J,Cai QH,et al.CDH17 alters MMP-2 expression via canonical NF-κB signalling in human gastric cancer[J].Gene,2018,1119(18):30531-30536.
[12]Xu J,E C,Yao Y,et al.Matrix metalloproteinase expression and molecular interaction network analysis in gastric cancer[J].Oncol Lett,2016,12(4):2403-2408.
[13]Zhang Y,Zheng W,Shen K,et al.Δ9-tetrahydrocannabinol inhibits epithelial-mesenchymal transition and metastasis by targeting matrix metalloproteinase-9 in endometrial cancer[J].Oncol Lett,2018,15(6):8527-8535.
[14]Pietruszewska W,Bojanowska-Po7niak K,Kobos J.Matrix metalloproteinases MMP1,MMP2,MMP9 and their tissue inhibitors TIMP1,TIMP2,TIMP3 in head and neck cancer:an immunohistochemical study[J].Otolaryngol Pol,2016,70(3):32-43.