女性乳腺癌骨转移相关因素分析  

Analysis on factors associated with bone metastasis in female breast cancer patients

作　　者：陈济[1] 雍伟[2] 张纪良[1] 陈维永[1] 李荣惠 龙丹 谢礼燕 CHEN Ji;YONG Wei;ZHANG Jiliang;CHEN Weiyong;LI Ronghui;LONG Dan;XIE Liyan(Department of Oncology,the Seventh People’s Hospital of Chengdu,Chengdu Tumor Hospital,Sichuan,Chengdu 610041,China;Department of Thyroid and Breast Surgery,the Seventh people’s Hospital of Chengdu,Chengdu Tumor Hospital,Sichuan,Chengdu 610041,China;Link Technology(Beijing)Co.,Ltd.,Beijing 100000,China)

机构地区：[1]成都市第七人民医院成都市肿瘤医院肿瘤科,四川成都610041 [2]成都市第七人民医院成都市肿瘤医院甲乳外科,四川成都610041 [3]零氪科技(北京)有限公司,北京100000

出　　处：《中国医药科学》2022年第16期18-22,共5页China Medicine And Pharmacy

基　　金：四川省医学科研青年创新课题(Q16005)。

摘　　要：目的分析女性乳腺癌发生骨转移的相关因素。方法利用零氪科技(北京)有限公司构建的成都市肿瘤医院患者数据库及其展示平台,选取2015年9月至2019年9月241例女性乳腺癌患者,观察年龄、病理类型、月经状态、骨转移部位、肿瘤大小、淋巴结转移情况、肿瘤分期、其他脏器转移情况、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(Her-2)状态、肿瘤标志物癌胚抗原(CEA)、糖类抗原153(CA-153)、糖类抗原125(CA-125)及增殖指数-67(Ki-67)表达水平等指标,探讨以上各因素与骨转移发生的相关性。结果乳腺癌骨转移高发部位以脊柱(68.3%)、骨盆(50.8%)、胸部骨骼(34.9%)为主。乳腺癌骨转移的发生与淋巴结转移、Her-2表达、其他脏器转移情况及CEA、CA-153、CA-125表达水平有关(P<0.05),而与患者年龄、肿瘤病理类型、月经状态、肿瘤大小、肿瘤分期、Ki-67、ER、PR表达无关(P>0.05)。CEA、CA-125、CA-153预测乳腺癌骨转移的曲线下面积(AUC)分别为0.808、0.868、0.801(均P<0.05)。结论乳腺癌患者初诊时淋巴结转移数目越多、合并其他脏器转移、Her-2表达阳性及CEA、CA-153、CA-125高表达均是女性乳腺癌患者发生骨转移的高危因素。Objective To analyze the factors associated with the occurrence of bone metastasis in female breast cancer(FBC)patients.Methods Using the patient database of Chengdu Tumor hospital and its display platform constructed by Link Technology(Beijing)Co.,Ltd.,241 female breast cancer patients from September 2015 to September 2019 were selected to observe their age,pathological type,menstrual status,bone metastasis location,tumor size,lymph node metastasis,tumor stage,metastasis of other organs,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER-2)receptor status,tumor markers carcino embryonic antigen(CEA),carbohydrate antigen 153(CA-153),carbohydrate antigen 125(CA-125)and proliferation index-67(Ki-67)expression level and other indicators.To explore the correlation between the above factors and bone metastasis.Results The high incidence of bone metastases from breast cancer was mainly in the spine(68.3%),pelvis(50.8%)and chest bone(34.9%).The occurrence of bone metastases from breast cancer was associated with lymph node metastases,Her-2 expression,other organ metastases and the expression levels of CEA,CA-153,CA-125(P<0.05),but not with patient age,pathological type of tumor,menstrual status,tumor size,tumor stage,and the expression of Ki-67,ER and PR(P>0.05).The AUC of serum CEA,CA-125 and CA-153 in predicting bone metastasis of breast cancer were 0.808,0.868 and 0.801 respectively(all P<0.05).Conclusion The high number of lymph node metastases,concomitant other organ metastases,Her-2-positive and high expression of CEA,CA-153 and CA-125 at the initial diagnosis of breast cancer are all high-risk factors for bone metastases in FBC pat ients.

关 键 词：乳腺癌 骨转移 高发部位 相关因素 

分 类 号：R737.9[医药卫生—肿瘤]