血清HER2 ECD+VEGF+HE4对乳腺癌术后复发转移的诊断价值
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摘要
目的比较血清人类表皮生长因子受体2胞外片段(HER2 ECD)、人附睾蛋白4(HE4)、血管内皮细胞生长因子(VEGF)和HER2 ECD+VEGF+HE4在乳腺癌术后复发转移中的诊断价值,以期选择最佳的检测方法,提高检测乳腺癌术后复发转移的灵敏度。方法选取接受手术治疗的86例乳腺癌患者作为研究对象,其中,术后复发转移患者34例(复发组),术后未复发转移患者52例(未复发组);另选取同期体检的40例健康女性作为对照组。检测3组受试者的血清HER2 ECD、VEGF、HE4水平。以病理学诊断结果作为金标准,分析不同检测方法对乳腺癌术后复发转移的的诊断效能。结果复发组患者的血清HER2 ECD、VEGF、HE4水平均高于未复发组和对照组,差异均有统计学意义(P﹤0.05);未复发组患者的血清VEGF、HE4水平均高于对照组,差异均有统计学意义(P﹤0.05)。血清HER2 ECD+VEGF+HE4联合检测乳腺癌术后复发转移的灵敏度为88.24%(30/34),特异度为86.54%(45/52),漏诊率为11.76%(4/34),误诊率为13.46%(7/52)。结论血清HER2 ECD+VEGF+HE4联合检测较三者单独检测能够提高对乳腺癌术后复发转移诊断的灵敏度,具有较高的临床诊断价值。
Objective To compare the diagnostic value of serum level of human epidermal growth factor receptor 2 extracellular domain(HER2 ECD),human epididymis protein 4(HE4),vascular endothelial growth factor(VEGF) and HER2 ECD+VEGF+HE4 in breast cancer recurrence and metastasis after operation,in order to determine the optimal detection method and improve the sensitivity of detection of postoperative recurrence and metastasis of breast cancer.Method Eighty-six patients with breast cancer who received surgical treatment were included in the study,including 34 cases with postoperative recurrence and metastasis(recurrence group),and 52 cases without recurrence and metastasis(non-recurrence group),besides,another 40 healthy women were recruited as control group.The serum HER2 ECD,VEGF and HE4 levels in three groups were measured.The diagnostic efficacy of different detection methods in the diagnosis of recurrence and metastasis of breast cancer after operation was analyzed based on the pathological findings,which was applied as the gold standard.Result The serum HER2 ECD,VEGF and HE4 levels in the recurrence group were higher than those in the non-recurrence group and the control group,with statistical significance observed(P<0.05).The serum levels of VEGF and HE4 in the non-recurrence group were higher than those in the control group(P<0.05).The sensitivity and specificity of serum HER2 ECD+VEGF+HE4 in detecting recurrence and metastasis of breast cancer after operation were 88.24%(30/34),86.54%(45/52),while the rate of missed diagnosis was 11.76%(4/34) and the misdiagnosis rate was 13.46%(7/52),respectively.Conclusion The combined detection of serum HER2 ECD + VEGF + HE4 can improve the sensitivity of diagnosis of recurrence and metastasis of breast cancer after operation,and is of high clinical value.
Objective To compare the diagnostic value of serum level of human epidermal growth factor receptor 2 extracellular domain(HER2 ECD),human epididymis protein 4(HE4),vascular endothelial growth factor(VEGF) and HER2 ECD+VEGF+HE4 in breast cancer recurrence and metastasis after operation,in order to determine the optimal detection method and improve the sensitivity of detection of postoperative recurrence and metastasis of breast cancer.Method Eighty-six patients with breast cancer who received surgical treatment were included in the study,including 34 cases with postoperative recurrence and metastasis(recurrence group),and 52 cases without recurrence and metastasis(non-recurrence group),besides,another 40 healthy women were recruited as control group.The serum HER2 ECD,VEGF and HE4 levels in three groups were measured.The diagnostic efficacy of different detection methods in the diagnosis of recurrence and metastasis of breast cancer after operation was analyzed based on the pathological findings,which was applied as the gold standard.Result The serum HER2 ECD,VEGF and HE4 levels in the recurrence group were higher than those in the non-recurrence group and the control group,with statistical significance observed(P<0.05).The serum levels of VEGF and HE4 in the non-recurrence group were higher than those in the control group(P<0.05).The sensitivity and specificity of serum HER2 ECD+VEGF+HE4 in detecting recurrence and metastasis of breast cancer after operation were 88.24%(30/34),86.54%(45/52),while the rate of missed diagnosis was 11.76%(4/34) and the misdiagnosis rate was 13.46%(7/52),respectively.Conclusion The combined detection of serum HER2 ECD + VEGF + HE4 can improve the sensitivity of diagnosis of recurrence and metastasis of breast cancer after operation,and is of high clinical value.
引文
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[5]袁静萍,袁修学,高利昆,等.转化生长因子-β1和血管内皮生长因子在乳腺癌中的表达及意义[J].中华内分泌外科杂志, 2017, 11(5):364-368.
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[8] Wu H, Song L, Chen L, et al. Injectable magnetic supramolecular hydrogel with magnetocaloric liquid-conformal property prevents post-operative recurrence in a breast cancer model[J]. Acta Biomater, 2018, 74:302-311.
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[10] Nayak A, Bleiweiss IJ, Dumoff K, et al. Mucinous cystadenocarcinoma of the breast:report of 2 cases including one with long-term local recurrence[J]. Int J Surg Pathol,2018, 26(8):749-757.
[11] Da Ros L, Moretti A, Querzoli P, et al. HER2-positive lobular versus ductal carcinoma of the breast:pattern of first recurrence and molecular insights[J]. Clin Breast Cancer,2018, 18(5):e1133-e1139.
[12]王慧杰.卡培他滨治疗复发转移乳腺癌的效果及其对患者血清癌胚抗原、糖链抗原19-9水平的影响研究[J].中国卫生检验杂志, 2017, 27(20):2974-2976.
[13]王丰莲,程旭锋,赵慧朵,等. T1期HER2阳性乳腺癌患者临床特征及抗HER2靶向治疗对预后的影响分析[J].癌症进展, 2018, 16(2):217-221.
[14]王英,李佩章,黄玲莎,等. HE4和CA153联合表达在预测早期乳腺癌淋巴结转移中的意义[J].现代肿瘤医学,2017, 25(3):390-392.
[15]赵丽辉,易冰,孟凤娇.乳腺浸润性导管癌TOP2A基因状态与HER2及临床病理特征的关系[J].江苏大学学报(医学版), 2018, 28(1):70-74.
[16]袁静萍,陈创,袁修学,等.乳腺癌中VEGF和MMP9的免疫组织化学表达及其与肿瘤转移复发的关系[J].中国组织化学与细胞化学杂志, 2016, 25(5):431-436.
[2] Atwal D, Ramos JM, Makhoul I. Late breast cancer recurrence with bone marrow metastases and acute pulmonary hypertension[J]. Proc(Bayl Univ Med Cent), 2018, 31(2):213-215.
[3]高亚丽,任铁军,薛琪,等. TIP30、EGFR在HER-2阳性乳腺癌诊疗中的价值探讨[J].中国妇幼保健, 2015, 30(10):1525-1527.
[4]郭变琴,吴立翔.血清人附睾蛋白4、糖类抗原153在监测术后乳腺癌复发转移的探讨[J].检验医学与临床, 2015,12(12):1676-1677; 1680.
[5]袁静萍,袁修学,高利昆,等.转化生长因子-β1和血管内皮生长因子在乳腺癌中的表达及意义[J].中华内分泌外科杂志, 2017, 11(5):364-368.
[6]刘崇,陈波,姜佳怡,等.血清CA153和HE4检测在乳腺癌的临床意义[J].中国微生态学杂志, 2015, 27(5):565-567.
[7]中华人民共和国卫生部医政司.乳腺癌诊疗规范(2011年版)[J].中国实用外科杂志, 2011, 31(10):902-907.
[8] Wu H, Song L, Chen L, et al. Injectable magnetic supramolecular hydrogel with magnetocaloric liquid-conformal property prevents post-operative recurrence in a breast cancer model[J]. Acta Biomater, 2018, 74:302-311.
[9] Wu J, Cao G, Sun X, et al. Intratumoral spatial heterogeneity at perfusion mr imaging predicts recurrence-free survival in locally advanced breast cancer treated with neoadjuvant chemotherapy[J]. Radiology, 2018, 288(1):26-35.
[10] Nayak A, Bleiweiss IJ, Dumoff K, et al. Mucinous cystadenocarcinoma of the breast:report of 2 cases including one with long-term local recurrence[J]. Int J Surg Pathol,2018, 26(8):749-757.
[11] Da Ros L, Moretti A, Querzoli P, et al. HER2-positive lobular versus ductal carcinoma of the breast:pattern of first recurrence and molecular insights[J]. Clin Breast Cancer,2018, 18(5):e1133-e1139.
[12]王慧杰.卡培他滨治疗复发转移乳腺癌的效果及其对患者血清癌胚抗原、糖链抗原19-9水平的影响研究[J].中国卫生检验杂志, 2017, 27(20):2974-2976.
[13]王丰莲,程旭锋,赵慧朵,等. T1期HER2阳性乳腺癌患者临床特征及抗HER2靶向治疗对预后的影响分析[J].癌症进展, 2018, 16(2):217-221.
[14]王英,李佩章,黄玲莎,等. HE4和CA153联合表达在预测早期乳腺癌淋巴结转移中的意义[J].现代肿瘤医学,2017, 25(3):390-392.
[15]赵丽辉,易冰,孟凤娇.乳腺浸润性导管癌TOP2A基因状态与HER2及临床病理特征的关系[J].江苏大学学报(医学版), 2018, 28(1):70-74.
[16]袁静萍,陈创,袁修学,等.乳腺癌中VEGF和MMP9的免疫组织化学表达及其与肿瘤转移复发的关系[J].中国组织化学与细胞化学杂志, 2016, 25(5):431-436.