首页|血清可溶性肿瘤坏死因子受体P55、金属硫蛋白1E对雌激素受体阳性乳腺癌根治术病人临床转归的影响

血清可溶性肿瘤坏死因子受体P55、金属硫蛋白1E对雌激素受体阳性乳腺癌根治术病人临床转归的影响

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目的 探讨血清可溶性肿瘤坏死因子受体P55(sTNFR-P55)、金属硫蛋白1E(MT1E)对雌激素受体(ER)阳性乳腺癌根治术病人临床转归的影响.方法 2017年2月~2018年3月在本院治疗的ER阳性乳腺癌根治术病人146例,依据术后临床转归情况分为复发转移组和未复发转移组,比较两组病人的临床资料、血清sTNFR-P55、MT1E水平.采用多因素Logistic回归分析影响ER阳性乳腺癌根治术病人临床转归的相关因素.制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)分析血清sTNFR-P55、MT1E及两者联合对ER阳性乳腺癌根治术病人临床转归的预测价值.结果 截止随访结束,146例ER阳性乳腺癌根治术病人共有32例发生复发转移.复发转移组肿瘤直径、肿瘤坏死因子-α、糖类抗原125(CA125)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)、肿瘤分期为Ⅲ期占比、血清sTNFR-P55、MT1E水平均高于未复发转移组(P<0.05).多因素 Logistic 回归分析显示,CYFRA21-1(OR=2.768,95%CI 1.107~6.920)、CEA(OR=2.751,95%CI 1.101~6.879)、肿瘤分期为 Ⅲ期(OR=3.611,95%CI 1.444~9.029)、sTNFR-P55(OR=3.343,95%CI 1.337~8.361)及 MT1E(OR=3.267,95%CI 1.307~8.169)均为影响ER阳性乳腺癌根治术病人临床转归的相关因素(P<0.05).ROC曲线分析结果显示,血清sTNFR-P55、MT1E及两者联合对ER阳性乳腺癌根治术病人临床转归预测的灵敏度分别为 78.12%(95%CI 59.56~90.06)、75.00%(95%CI 56.25~87.87)、71.88%(95%CI 53.02~85.60),特异度分别为 63.16%(95%CI 53.56~71.85)、75.44%(95%CI 66.32~82.80)、96.49%(95%CI 90.73~98.87),AUC 分别为 0.723(95%CI 0.642~0.793)、0.760(95%CI 0.682~0.827)、0.880(95%CI 0.816~0.928).结论 血清 sTNFR-P55、MT1E 与 ER 阳性乳腺癌根治术病人临床转归有关,且血清sTNFR-P55、MT1E两者联合对ER阳性乳腺癌根治术病人临床转归预测效能较高.
Effect of serum tumor necrosis factor receptor P55 and metallothionein 1E on clinical outcome of estrogen receptor positive breast cancer patients undergoing radical mastectomy
Objective To investigate the effect of serum soluble tumor necrosis factor receptor P55(sTNFR-P55)and metallothionein 1E(MT1E)on the clinical outcome of estrogen receptor(ER)positive breast cancer patients undergoing radical mastectomy.Methods The clinical data of 146 patients with ER positive breast cancer who were treated in our hospital from February 2017 to March 2018 were retrospectively analyzed.According to the clinical outcome of patients after surgery,they were divided into recurrent metastatic group and non-recurrent metastatic group.The clinical data,serum sTNFR-P55 and MT1E levels were compared between patients with recurrent metastatic group and non-recurrent metastatic group.Multivariate Logistic regression analysis was used to analyze the related factors influencing the clinical outcome of ER positive breast cancer patients undergoing radical mastectomy.The receiver operating characteristic curve(ROC)was made,and the area under the curve(AUC)was used to analyze the predictive value of serum sTNFR-P55,MT1E and their combination on the clinical outcome of ER positive breast cancer patients undergoing radical surgery.Results By the end of follow-up,32 of 146 patients with ER positive breast cancer had recurrence and metastasis.Tumor size and levels of tumor necrosis factor-α,carbohydrate antigen 125(CA125),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),tumor stage Ⅲ,serum sTNFR-P55 and MT1E in the recurrent metastatic group were higher than those in the non-recurrent metastatic group(P<0.05).Multivariate Logistic analysis showed that CYFRA21-1(OR=2.768,95%CI 1.107-6.920),CEA(OR=2.751,95%CI 1.101-6.879),tumor stage Ⅲ(OR=3.611,95%CI 1.444-9.029),sTNFR-P55(OR=3.343,95%CI 1.337-8.361)and MT1 E(OR=3.267,95%CI 1.307-8.169)were all related factors affecting the clinical outcome of ER positive breast cancer patients undergoing radical surgery(P<0.05).ROC curve analysis results showed that the sensitivity of serum sTNFR-P55,MT1E and their combination in predicting the clinical outcome of ER positive breast cancer patients undergoing radical surgery was 78.12%(95%CI 59.56-90.06),75.00%(95%CI 56.25-87.87)and 71.88%(95%CI 53.02-85.60),respectively.The specificity was 63.16%(95%CI 53.56-71.85),75.44%(95%CI 66.32-82.80)and 96.49%(95%CI 90.73-98.87),respectively.AUC was 0.723(95%CI0.642-0.793),0.760(95%CI0.682-0.827)and 0.880(95%CI0.816-0.928)respectively.Conclusion Serum sTNFR-P55 and MT1E are related to the clinical outcome of ER positive breast cancer patients undergoing radical mastectomy,and the combination of serum sTNFR-P55 and MT1E is more effective in predicting the clinical outcome of ER positive breast cancer patients undergoing radical mastectomy.

breast cancerestrogen receptor positiveradical mastectomy for breast cancersoluble tumor necrosis factor receptor P55metallothionein 1Eclinical outcome

申永强、王辉、潘驰

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226500 江苏省如皋市人民医院普外科

乳腺癌 雌激素受体阳性 乳腺癌根治术 可溶性肿瘤坏死因子受体P55 金属硫蛋白1E 临床转归

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(5)
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