血清CA15-3、CA125联合MMP-1和IL-10检测在乳腺癌诊断和预后评估中的价值探讨
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摘要
目的探究血清CA15-3、CA125联合基质金属蛋白酶-1(MMP-1)和白细胞介素-10(IL-10)水平在乳腺癌(BC)诊断和预后评估中的临床价值。方法收集2014年1月至2016年1月期间入我院就诊的BC患者104例,同期选取健康体检者80例。采用t检验分析血清CA15-3、CA125、MMP-1和IL-10在组间的差异,运用受试者工作特征曲线(ROC)技术分析血清CA15-3、CA125、MMP-1和IL-10在鉴别诊断BC的临床价值。相关性分析采用Spearman检验。多项Logistic回归分析计算(OR)及其95%置信区间(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,BC患者血清CA15-3、CA125、MMP-1和IL-10水平均显著增高(P均<0.05)。ROC曲线分析显示,当联合血清CA15-3、CA125、MMP-1和IL-10在区分BC与健康对照组时的灵敏度和特异性均明显提升,分别为91.5%和93.0%。多元Logistic回归多因素分析显示,在校正年龄、吸烟、饮酒、糖尿病和CA125等因素影响后,高MMP-1、高IL-10和高BMI是BC的独立危险因素。生存分析显示,高MMP-1组患者的生存时间显著低于低MMP-1组患者(log-rank P=0.035),而血清高IL-10与低IL-10组间的生存时间差异无统计学意义(log-rank P=0.475)。结论血清MMP-1和IL-10联合CA15-3和CA125在BC诊断中以及血清MMP-1在评估BC患者预后中均具有重要临床意义。
Objective To explore the clinical value of serum CA15-3, CA125 combined with matrix metalloproteinase-1(MMP-1) and interleukin-10(IL-10) level in diagnosis and prognosis evaluation of breast cancer(BC). Methods A total of 104 BC patients were enrolled in our hospital from January 2014 to January 2016,and 80 healthy cases were selected at the same time. The differences of serum CA15-3,CA125,MMP-1 and IL-10 between groups were analyzed by t test. The clinical value of serum CA15-3,CA125,MMP-1 and IL-10 in the differential diagnosis of BC was analyzed by receiver operating characteristic curve(ROC). Spearman test was used for the correlation analysis. Multiple logistic regression was used to analyses the ORs and its 95% confidence intervals(CIs). The Kaplan-Meier method and the logarithmic rank test(log-rank test) were used for survival analysis. Results Compared with the health group, the levels of CA15-3,CA125,MMP-1 and IL-10 in the serum of BC patients were significantly higher(P <0. 05). ROC curve analysis showed that the sensitivity and specificity of combined serum CA15-3,CA125,MMP-1 and IL-10 in differentiating BC and healthy controls significantly increased, which were 91. 5% and 93%respectively. Multivariate logistic regression analysis showed that high MMP-1, high IL-10 and high BMI were independent risk factors of BC after adjusting for age, smoking, drinking, diabetes and CA125. Survival analysis showed that the survival time of patients in high MMP-1 group was significantly lower than that in low MMP-1 group(log-rank P =0.035),but there was no significant difference in the survival time between high serum IL-10 and low IL-10 group(log-rank P =0. 475). Conclusion The diagnostic value of serum MMP-1 and IL-10 combined with CA15-3 and CA125 in BC and the important clinical significance of serum MMP-1 in evaluating the prognosis of BC patients.
Objective To explore the clinical value of serum CA15-3, CA125 combined with matrix metalloproteinase-1(MMP-1) and interleukin-10(IL-10) level in diagnosis and prognosis evaluation of breast cancer(BC). Methods A total of 104 BC patients were enrolled in our hospital from January 2014 to January 2016,and 80 healthy cases were selected at the same time. The differences of serum CA15-3,CA125,MMP-1 and IL-10 between groups were analyzed by t test. The clinical value of serum CA15-3,CA125,MMP-1 and IL-10 in the differential diagnosis of BC was analyzed by receiver operating characteristic curve(ROC). Spearman test was used for the correlation analysis. Multiple logistic regression was used to analyses the ORs and its 95% confidence intervals(CIs). The Kaplan-Meier method and the logarithmic rank test(log-rank test) were used for survival analysis. Results Compared with the health group, the levels of CA15-3,CA125,MMP-1 and IL-10 in the serum of BC patients were significantly higher(P <0. 05). ROC curve analysis showed that the sensitivity and specificity of combined serum CA15-3,CA125,MMP-1 and IL-10 in differentiating BC and healthy controls significantly increased, which were 91. 5% and 93%respectively. Multivariate logistic regression analysis showed that high MMP-1, high IL-10 and high BMI were independent risk factors of BC after adjusting for age, smoking, drinking, diabetes and CA125. Survival analysis showed that the survival time of patients in high MMP-1 group was significantly lower than that in low MMP-1 group(log-rank P =0.035),but there was no significant difference in the survival time between high serum IL-10 and low IL-10 group(log-rank P =0. 475). Conclusion The diagnostic value of serum MMP-1 and IL-10 combined with CA15-3 and CA125 in BC and the important clinical significance of serum MMP-1 in evaluating the prognosis of BC patients.
引文
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[14]ALOTAIBI M R,HASSAN Z K,AL-REJAIE S S,et al.Characterization of Apoptosis in a Breast Cancer Cell Line after IL-10 Silencing[J].Asian Pac J Cancer Prev,2018,19(3):777-783.
[15]BHATTACHARJEE H K,BANSAL V K,NEPAL B,et al.Is Interleukin 10(IL10)Expression in Breast Cancer a Marker of Poor Prognosis[J]?Indian J Surg Oncol,2016,7(3):320-325.
[16]BLACKWELL K,GASCON P,JONES C M,et al.Pooled analysis of two randomized,double-blind trials comparing proposed biosimilar LAEP2006 with reference pegfilgrastim in breast cancer[J].Ann Oncol,2017,28(9):2272-2277.
[17]ULIANA C V,PEVERARI C R,AFONSO A S,et al.Fully disposable microfluidic electrochemical device for detection of estrogen receptor alpha breast cancer biomarker[J].Biosens Bioelectron,2018,99:156-162.
[2]陈万青,郑荣寿.中国女性乳腺癌发病死亡和生存状况[J].中国肿瘤临床,2015,42(13):668-674.
[3]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.
[4]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.
[5]刘苑欢,魏荣兴,邱群芳.联合检测CA15-3、CA125、CEA对乳腺癌临床诊断价值探讨[J].实用癌症杂志,2014,29(4):406-408.
[6]李乔,尹如铁,周乐,等.IL-10免疫黏附素和肿瘤相关巨噬细胞对卵巢癌侵袭性的研究[J].华西药学杂志,2017,32(3):257-259.
[7]于丹军,樊静,胡月,等.妇科肿瘤患者外周血中调节性T细胞和血清中TGF-β、IL-10的变化及相关性研究[J].河北医科大学学报,2016,37(11):1307-1311,1316.
[8]孙振华,赵志泓,蒋华平,等.肿瘤微环境相关因子IL-6、IL-10、CXCR7在甲状腺乳头状癌中的表达及临床意义[J].中国普通外科杂志,2017,26(5):578-582.
[9]QU K,PANG Q,LIN T,et al.Circulating interleukin-10 levels and human papilloma virus and Epstein-Barr virus-associated cancers:evidence from a Mendelian randomization meta-analysis based on11,170 subjects[J].Onco Targets Ther,2016,7(9):1251-1267.
[10]XU J,E C,YAO Y,REN S,et al.Matrix metalloproteinase expression and molecular interaction network analysis in gastric cancer[J].Oncol Lett,2016,12(4):2403-2408.
[11]PIETRUSZEWSKA W,BOJANOWSKA-PO Z NIAK 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.
[12]ABRAHAMSSON A,RZEPECKA A,DABROSIN C.Equal proinflammatory profiles of CCLs,CXCLs,and matrix metalloproteinases in the extracellular microenvironment in vivo in human dense breast tissue and breast cancer[J].Front Immunol,2018,8:1994.
[13]BENSON C S,BABU S D,RADHAKRISHNA S,et al.Expression of matrix metalloproteinases in human breast cancer tissues[J].Dis Markers,2013,34(6):395-405.
[14]ALOTAIBI M R,HASSAN Z K,AL-REJAIE S S,et al.Characterization of Apoptosis in a Breast Cancer Cell Line after IL-10 Silencing[J].Asian Pac J Cancer Prev,2018,19(3):777-783.
[15]BHATTACHARJEE H K,BANSAL V K,NEPAL B,et al.Is Interleukin 10(IL10)Expression in Breast Cancer a Marker of Poor Prognosis[J]?Indian J Surg Oncol,2016,7(3):320-325.
[16]BLACKWELL K,GASCON P,JONES C M,et al.Pooled analysis of two randomized,double-blind trials comparing proposed biosimilar LAEP2006 with reference pegfilgrastim in breast cancer[J].Ann Oncol,2017,28(9):2272-2277.
[17]ULIANA C V,PEVERARI C R,AFONSO A S,et al.Fully disposable microfluidic electrochemical device for detection of estrogen receptor alpha breast cancer biomarker[J].Biosens Bioelectron,2018,99:156-162.