术前血清血管内皮生长因子对乳腺疾病的鉴别诊断意义  

The significance of preoperative serum vascular endothelial growth factor in the differential diagnosis of breast diseases

作　　者：刘喻 王磊[1] 於恩桥[1] 孙洁[1] 刘建夏[1] LIU Yu;WANG Lei;YU Enqiao;SUN Jie;LIU Jianxia(Department of Thyroid and Breast Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院甲乳外科,江苏苏州215006

出　　处：《中国肿瘤外科杂志》2020年第1期23-27,共5页Chinese Journal of Surgical Oncology

基　　金：吴阶平医学基金会(31010303010950)。

摘　　要：目的探讨术前血清血管内皮生长因子(sVEGF)对乳腺疾病的鉴别诊断意义。方法收集苏州大学附属第一医院甲乳外科2018年7月至2018年12月收治的110例乳腺癌(恶性组)和47例乳腺良性疾病(良性组)患者术前血液标本,比较恶性组与良性组间sVEGF水平的差别,分析乳腺癌患者不同临床特征间sVEGF水平的差别。采用Pearson线性相关分析乳腺癌患者sVEGF与其他指标的相关性。绘制受试者工作特征曲线评价乳腺癌患者sVEGF、术前腋窝B超及sVEGF联合术前腋窝B超对腋窝淋巴结转移的预测价值。结果恶性组与良性组间sVEGF水平差异无统计学意义(80.53 vs.75.41,Z=-0.646,P=0.518);乳腺癌有腋窝淋巴结转移患者的sVEGF水平高于无腋窝淋巴结转移患者(65.95 vs.49.76),差异有统计学意义(Z=-2.546,P=0.011)。不同临床分期乳腺癌患者的sVEGF水平差异有统计学意义,Ⅳ期高于Ⅰ期(97.00 vs.48.23),Ⅲ期高于Ⅰ期(73.09 vs.48.23),差异均有统计学意义(P<0.05);乳腺癌患者的sVEGF水平与血小板水平呈正比(r=0.241,P=0.036)。sVEGF联合术前腋窝B超诊断腋窝淋巴结是否有转移的诊断效能最高,其工作特征曲线下面积(AUC)为0.797。结论术前sVEGF水平对乳腺良恶性疾病无鉴别诊断意义,但对乳腺癌患者有无腋窝淋巴结转移及判断临床分期有诊断意义。Objective To retrospectively analyze the significance of preoperative serum vascular endothelial growth factor in the differential diagnosis of breast diseases.Methods The preoperative blood samples of 110 cases of breast cancer and 47 cases of benign patients were collected from July to December,2018,in the first affiliated hospital of Soochow University.The sVEGF content in the benign and malignant breasts was analyzed.And the relationship between sVEGF and pathological nature of breast cancer was analysed.Pearson linear correlation was used to analyze the correlation between sVEGF and other clinical features in breast cancer patients.ROC curve was used to evaluate the predictive value of sVEGF,preoperative axillary ultrasound and sVEGF combined with preoperative axillary ultrasound for axillary lymph node metastasis in breast cancer patients.Results There was no difference in sVEGF content between patients with benign and malignant diseases(75.41 vs.80.53,Z=-0.646,P=0.518).There was a statistically significant difference in preoperative sVEGF levels between patients with axillary lymph node metastasis and those without axillary lymph node metastasis(65.95 vs.49.76,Z=-2.546,P=0.011).Patients with different clinical stages of breast cancer had a significant difference in sVEGF levels,stage Ⅳ was higher than stage Ⅰ and Ⅱ(97.00 vs.48.23),stage Ⅲ was higher than stageⅠ(73.09 vs.48.23),the difference was statistically significant(P<0.05).sVEGF content was proportional to platelet content(r=0.241,P=0.036).The accuracy of sVEGF combined with preoperative axillary ultrasound in the diagnosis of axillary lymph nodes metastasis was the highest with the area under the curve being at 0.797.Conclusions Preoperative sVEGF level had no significance in the differential diagnosis of benign and malignant breast diseases,but it was of diagnostic significance for the presence and absence of axillary lymph node metastasis and the determination of clinical stage in breast cancer patients.

关 键 词：乳腺癌 血清血管内皮生长因子 CA153 CA125 肿瘤特异性生长因子 血小板 

分 类 号：R737.9[医药卫生—肿瘤]