血清碱性磷酸酶、乳酸脱氢酶对乳腺癌患者生存预后的评估价值
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摘要
目的探讨血清碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)对乳腺癌患者生存预后的评估价值。方法回顾性分析Ⅱ～Ⅲ期乳腺癌患者64例作为研究对象,所有患者均行外科根治术与术后常规辅助放化疗,治疗后随访3年,根据随访期间是否发生肿瘤复发分为肿瘤复发转移组(n=34)与非复发转移组(n=30),分析两组患者治疗前后血清ALP、LDH水平变化,及其与患者预后的关系。结果复发转移组治疗前后ALP水平高于非复发转移组(P <0. 05);两组患者治疗前血清LDH水平比较差异无统计学意义(P> 0. 05),治疗后复发转移组患者血清LDH水平明显高于非复发转移组的(P <0. 05); Spearman相关性分析显示,治疗后血清碱性磷酸酶、乳酸脱氢酶水平与中期乳腺癌患者治疗后肿瘤复发转移发生风险呈正相关关系(γ=0. 588,γ=0. 439,P <0. 05); ROC曲线分析显示:联合治疗后血清ALP+LDH水平预测中期乳腺癌患者治疗后3年内发生肿瘤复发转移明显高于血清ALP、LDH单项预测的。结论乳腺癌患者治疗后血清碱性磷酸酶、乳酸脱氢酶水平与治疗后肿瘤复发转移具有一定相关性,可作为生存预后评估辅助指标之一。
Objective To evaluate the prognostic value of serum alkaline phosphatase( ALP) and lactate dehydrogenase( LDH) in patients with advanced breast cancer. Methods 64 patients diagnosed with stage Ⅱ ～ Ⅲ breast cancer were selected as the study subjects. All the patients underwent radical surgery and conventional adjuvant chemoradiotherapy after follow-up for 3 years,according to whether tumor recurrence during follow-up was divided into tumor recurrence and metastasis and non-recurrence metastasis,the changes of serum ALP and LDH levels before and after treatment in both groups were analyzed,The relationship between tumor recurrence and metastasis after treatment. Results The ALP level in the recurrence and metastasis group was higher than that of the non-recurrence group. There was no significant difference in serum LDH levels between the 2 groups before treatment. Serum LDH levels in the patients with recurrent or metastatic disease were significantly higher than those of the non-recurrent metastatic group. Spearman correlation analysis showed that serum ALP and LDH levels were positively correlated with the recurrence and metastasis of breast cancer patients after treatment( γ = 0. 588,γ = 0. 439,P < 0. 05). ROC curve analysis showed that serum ALP + LDH level after combination therapy predicted the tumor recurrence and metastasis within 3 years after treatment in patients with advanced breast cancer was significantly higher than the single predictions of serum ALP and LDH. Conclusion Serum alkaline phosphatase and lactate dehydrogenase levels in patients with advanced breast cancer after treatment are correlated with tumor recurrence and metastasis after treatment,which can be used as an adjunct to survival prognosis evaluation.
Objective To evaluate the prognostic value of serum alkaline phosphatase( ALP) and lactate dehydrogenase( LDH) in patients with advanced breast cancer. Methods 64 patients diagnosed with stage Ⅱ ～ Ⅲ breast cancer were selected as the study subjects. All the patients underwent radical surgery and conventional adjuvant chemoradiotherapy after follow-up for 3 years,according to whether tumor recurrence during follow-up was divided into tumor recurrence and metastasis and non-recurrence metastasis,the changes of serum ALP and LDH levels before and after treatment in both groups were analyzed,The relationship between tumor recurrence and metastasis after treatment. Results The ALP level in the recurrence and metastasis group was higher than that of the non-recurrence group. There was no significant difference in serum LDH levels between the 2 groups before treatment. Serum LDH levels in the patients with recurrent or metastatic disease were significantly higher than those of the non-recurrent metastatic group. Spearman correlation analysis showed that serum ALP and LDH levels were positively correlated with the recurrence and metastasis of breast cancer patients after treatment( γ = 0. 588,γ = 0. 439,P < 0. 05). ROC curve analysis showed that serum ALP + LDH level after combination therapy predicted the tumor recurrence and metastasis within 3 years after treatment in patients with advanced breast cancer was significantly higher than the single predictions of serum ALP and LDH. Conclusion Serum alkaline phosphatase and lactate dehydrogenase levels in patients with advanced breast cancer after treatment are correlated with tumor recurrence and metastasis after treatment,which can be used as an adjunct to survival prognosis evaluation.
引文
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[9]Chen B,Dai D,Tang H,et al.Pre-treatment serum alkaline phosphatase and lactate dehydrogenase as prognostic factors in triple negative breast cancer[J].Cancer,2016,7(15):2309-2316.
[2]Petekkaya I,Aksoy S,Roach EC,et al.Impact of inflammatory markers on the prognosis of patients with operable breast cancer[J].BUON,2014,19(3):80-673.
[3]Hussien R,Brooks GA.Mitochondrial and plasma membrane lactate transporter and lactate dehydrogenase isoform expression in breast cancer cell lines[J].Physiol Genomics,2011,43(5):64-255.
[4]Brown JE,Cook RJ,Lipton A,et al.Serum lactate dehydrogenase is prognostic for survival in patients with bone metastases from breast cancer:a retrospective analysis in bisphosphonate-treated patients[J].Clin Cancer Res,2012,18(22):55-6348.
[5]Chang CC,Zhang C,Zhang Q,et al.Upregulation of lactate dehydrogenase a by 14-3-3ζleads to increased glycolysis critical for breast cancer initiation and progression[J].Oncotarget,2016,7(23):83-35270.
[6]盛雅娟,刘卫国.乳腺癌复发/转移部位及生存与血清癌抗原15-3、碱性磷酸酶水平的关系[J].中华实验外科杂志,2012,29(11):2291-2293.
[7]Sarvari BK,Sankara Mahadev D,Rupa S,et al.Detection of Bone Metastases in Breast Cancer(BC)Patients by Serum Tartrate-Resistant Acid Phosphatase 5b(TRACP 5b),a Bone Resorption Marker and Serum Alkaline Phosphatase(ALP),a Bone Formation Marker,in Lieu of Whole Body Skeletal Scintigraphy with Technetium99m MDP[J].Indian J Clin Biochem,2015,30(1):66-71.
[8]李永宪,纪术峰,胡海燕.乳腺癌骨转移患者血清骨型碱性磷酸酶及瘦素水平[J].广东医学,2012,33(23):3601-3602.
[9]Chen B,Dai D,Tang H,et al.Pre-treatment serum alkaline phosphatase and lactate dehydrogenase as prognostic factors in triple negative breast cancer[J].Cancer,2016,7(15):2309-2316.