乳腺癌患者血清甲状腺激素水平及其与CA153、Ki67、ER、高敏C-反应蛋白水平的相关性研究
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摘要
目的探讨乳腺癌患者治疗前后甲状腺激素(thyroid hormone, TH)、ER、CA153和高敏C-反应蛋白(high-sensitive C-reactive protein, hs-CRP)的水平及关系,为乳腺癌患者疾病发展、治疗及判断预后提供参考价值。方法采用化学发光免疫分析和免疫比浊定量法测定了156例乳腺癌患者治疗前后和60例正常对照组血清TH,包括3,3,5-三碘-L-甲腺原氨酸O-(4-Hydroxy-3-iodophenyl)-3,5-diiodo-L-tyrosine,T_3]、L-甲状腺素(L-thyroxine, T_4)和促甲状腺激素(thyroid stimulating hormone, TSH), CA153、Ki67、ER和hs-CRP水平,进行了对比性分析。结果与正常对照组相比,治疗前乳腺癌患者血清T_3水平明显降低,而血清CA153、hs-CRP水平明显增高且有统计学差异(P<0.05),血清T_4和TSH水平无明显差异(P>0.05);与治疗前相比,治疗后乳腺癌患者血清CA153、hs-CRP水平明显降低,而T_3水平上升且有统计学差异(P<0.05),血清T_4和TSH水平无明显差异(P>0.05)。Pearson相关分析,结果提示ER表达情况和Ki67值与T_3、CA153和hs-CRP存在相关关系(P<0.05),而与T_4、TSH均无相关关系(P>0.05)。T_3下降水平与年龄、肿瘤大小无关,与淋巴结转移、肿瘤病理类型和TNM分期相关(P<0.05)。T_3值越低,肿瘤直径越大,淋巴结转移、临床分期越晚。结论对乳腺癌患者治疗期间内定期测定T_3、血清CA153和hs-CRP水平对临床了解乳腺癌患者病情具有重要的临床价值。
Objective To explore the treatment of breast cancer patients before and after thyroid hormone(thyroid hormone, TH, ER, CA153) and high sensitive C-reactive protein(hs-CRP) and the level of relationship, so as to provide reference for the treatment and judging the prognosis of breast cancer patients and disease development. Methods TH in 156 patients with breast cancer before and after treatment and 60 controls was detected by chemiluminescence immune analysis and immunohistochemistry, includingT_3, T_4 TSH, CA153 and hs-CRP levels, and the results were analyzed and compared. Results Compared with the control group, T_3 level before treatment in patients with breast cancer significantly decreased, while serum CA153 and hs-CRP levels increased, with the differences statistically significant(P<0.05), there was no significant difference between serum T_4 and TSH levels; compared with that before treatment, serum CA153 and hs-CRP levels in breast cancer patients significantly reduced after treatment, while the T_3 level increased and there was statistical significance on the difference(P<0.05). There was no significant difference between serum T_4 and TSH levels. Pearson correlation analysis was used discuss the relationship of Ki67 in patients with breast cancer with thyroid hormone levels, CA153 and hs-CRP, and the results suggested that ER expression and Ki67 value were correlated with T_3, CA153 and hs-CRP(P<0.05), while there was no correlation with TSH and T_4(P>0.05). T_3 decrease had no correlation with age, tumor pathological type(P>0.05). The lower the T_3 value, the larger the tumor diameter, and the later lymph node metastasis and clinical stage. Conclusion It is of great clinical value to determine the clinical value of T_3, serum CA153 and hs-CRP levels in patients with breast cancer in the treatment of breast cancer patients.
Objective To explore the treatment of breast cancer patients before and after thyroid hormone(thyroid hormone, TH, ER, CA153) and high sensitive C-reactive protein(hs-CRP) and the level of relationship, so as to provide reference for the treatment and judging the prognosis of breast cancer patients and disease development. Methods TH in 156 patients with breast cancer before and after treatment and 60 controls was detected by chemiluminescence immune analysis and immunohistochemistry, includingT_3, T_4 TSH, CA153 and hs-CRP levels, and the results were analyzed and compared. Results Compared with the control group, T_3 level before treatment in patients with breast cancer significantly decreased, while serum CA153 and hs-CRP levels increased, with the differences statistically significant(P<0.05), there was no significant difference between serum T_4 and TSH levels; compared with that before treatment, serum CA153 and hs-CRP levels in breast cancer patients significantly reduced after treatment, while the T_3 level increased and there was statistical significance on the difference(P<0.05). There was no significant difference between serum T_4 and TSH levels. Pearson correlation analysis was used discuss the relationship of Ki67 in patients with breast cancer with thyroid hormone levels, CA153 and hs-CRP, and the results suggested that ER expression and Ki67 value were correlated with T_3, CA153 and hs-CRP(P<0.05), while there was no correlation with TSH and T_4(P>0.05). T_3 decrease had no correlation with age, tumor pathological type(P>0.05). The lower the T_3 value, the larger the tumor diameter, and the later lymph node metastasis and clinical stage. Conclusion It is of great clinical value to determine the clinical value of T_3, serum CA153 and hs-CRP levels in patients with breast cancer in the treatment of breast cancer patients.
引文
[1] 徐建红,钮丽萍.乳腺癌患者治疗前后测定血清甲状腺激素、CA153和高敏C-反应蛋白水平的临床价值[J].南通大学学报:医学版,2015,2:126-129.
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[3] 张建云.乳腺癌患者血清甲状腺激素水平变化及其与ER、PR、HER2、Ki67表达的相关性研究[D].太原:山西医科大学,2016.
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[5] Hardefeldt PJ,Eslick GD,Edirimanne S.Benign thyroid disease is associated with breast cancer:a meta-analysis[J].Breast Cancer Res Treat,2012,133(3):1169-1177.
[6] 陈梁.GDF3联合CA125、CA15-3和CEA等血清指标在乳腺癌诊断中的价值[D].承德:承德医学院,2014.
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[10] 蒋立,肖创清.血清TSH和甲状腺激素水平与乳腺癌关系的探讨[J].放射免疫学杂志,2012,25(3):254-255.
[11] North American Menopause Society.The 2012 hormone therapy position statement of:The North American Menopause Society[J].Menopause,2012,19(3):257-271.
[12] 任维维,米登海,李征,等.肺癌康复期癌因性疲乏患者血清甲状腺激素和促甲状腺激素水平的观察[J].中国肿瘤临床与康复,2016(7):693-695.
[13] 田甜,张淑群.甲状腺激素及其受体与乳腺癌的关系[J].现代肿瘤医学,2016,24(9):1483-1486.
[14] 邵茂斌,王迅,叶伟平,等.P16和Ki-67在宫颈病变中的表达及临床意义[J].中国卫生检验杂志,2017,27(19):2797-2798.
[15] 任圣男.乳腺癌伴发甲状腺疾病患者甲状腺功能的变化及临床意义[D].长春:吉林大学,2013.
[2] 张建云,李树峰,徐峰.不同HER2表达情况下乳腺癌患者甲状腺激素与Ki67的相关性[J].山西医科大学学报,2015,11:1132-1135.
[3] 张建云.乳腺癌患者血清甲状腺激素水平变化及其与ER、PR、HER2、Ki67表达的相关性研究[D].太原:山西医科大学,2016.
[4] 王红梅.血清AHSG抗体、SPAG9抗体、CA153、TPS不同组合对乳腺癌诊断的意义[D].长沙:中南大学,2012.
[5] Hardefeldt PJ,Eslick GD,Edirimanne S.Benign thyroid disease is associated with breast cancer:a meta-analysis[J].Breast Cancer Res Treat,2012,133(3):1169-1177.
[6] 陈梁.GDF3联合CA125、CA15-3和CEA等血清指标在乳腺癌诊断中的价值[D].承德:承德医学院,2014.
[7] 夏敏玲,陈思佳.乳腺癌患者血清甲状腺激素水平检测及其临床意义[J].中国病案,2011,12(10):68-69.
[8] 张立,吴万敏.乳腺癌患者血清甲状腺激素水平和甲状腺过氧化物酶抗体表达及其临床意义[J].中华乳腺病杂志:电子版,2011(4):459-465.
[9] De Martel C,Ferlay J,Franceschi S,et al.Glabal burder ofcancer attributable to infections in 2008:a review and synthelic analysis[J].Lancet Oncol,2012,13(6):607-615.
[10] 蒋立,肖创清.血清TSH和甲状腺激素水平与乳腺癌关系的探讨[J].放射免疫学杂志,2012,25(3):254-255.
[11] North American Menopause Society.The 2012 hormone therapy position statement of:The North American Menopause Society[J].Menopause,2012,19(3):257-271.
[12] 任维维,米登海,李征,等.肺癌康复期癌因性疲乏患者血清甲状腺激素和促甲状腺激素水平的观察[J].中国肿瘤临床与康复,2016(7):693-695.
[13] 田甜,张淑群.甲状腺激素及其受体与乳腺癌的关系[J].现代肿瘤医学,2016,24(9):1483-1486.
[14] 邵茂斌,王迅,叶伟平,等.P16和Ki-67在宫颈病变中的表达及临床意义[J].中国卫生检验杂志,2017,27(19):2797-2798.
[15] 任圣男.乳腺癌伴发甲状腺疾病患者甲状腺功能的变化及临床意义[D].长春:吉林大学,2013.