血清Cathe K、MGP、IGFBP-3预测乳腺癌根治术后骨质疏松发生风险  

Serum Cathe K,MGP,and IGFBP-3 predict the risk of osteoporosis after radical breast cancer surgery

作　　者：武倩[1] 高海华 苏红梅[1] 赵倩[1] Wu Qian;Gao Haihua;Su Hongmei;Zhao Qian(Department of Breast Surgery,Linyi People’s Hospital,Linyi 276000,China;Department of Reproductive Medicine,Linyi Maternal and Child Health Hospital,Linyi 276000,China)

机构地区：[1]临沂市人民医院乳腺外科,临沂276000 [2]临沂市妇幼保健院生殖医学科,临沂276000

出　　处：《中华内分泌外科杂志（中英文）》2024年第2期238-242,共5页Chinese Journal of Endocrine Surgery

基　　金：2020年山东省医学会乳腺疾病科研基金(YXH2020ZX070)。

摘　　要：目的探究血清组织蛋白酶K(cathepsin K,Cathe K)、基质gla蛋白(matrix gla protein,MGP)、胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein3,IGFBP-3)预测乳腺癌根治术后骨质疏松发生风险的价值。方法收集2019年6月至2021年6月于临沂市人民医院完成乳腺癌根治术及术后1年随访的150例女性乳腺癌患者作为研究对象,统计骨质疏松发生率。比较发生与未发生骨质疏松患者的临床资料、骨转换标志物[Ⅰ型前胶原氨基末端肽(typeⅠprocollagenamino-terminal peptide,PINP),Ⅰ型胶原交联C-末端肽(typeⅠcollagen carboxy-terminal peptide,CTX)]、血清Cathe K、MGP、IGFBP-3水平,分析血清Cathe K、MGP、IGFBP-3水平与骨转换标志物的相关性,并分析各指标预测乳腺癌根治术后骨质疏松发生风险的价值,对比血清Cathe K、MGP、IGFBP-3与骨转换标志物预测骨质疏松发生风险的价值。结果150例女性乳腺癌患者乳腺癌根治术后骨质疏松发生率为34.67%(52/150);发生骨质疏松患者血清Cathe K水平为(31.86±9.52)ng/L,高于未发生骨质疏松患者的(24.87±5.34)ng/L,血清MGP、IGFBP-3、PINP、CTX水平分别为(8.64±1.33)ng/ml、(10.13±2.29)μg/ml、(44.13±4.87)μg/L、(0.42±0.13)μg/L,低于未发生骨质疏松患者的(12.39±1.71)ng/ml、(13.10±2.63)μg/ml、(93.25±29.71)μg/L、(1.65±0.50)μg/L,均差异有统计学意义(t=5.77、13.75、6.88、11.82、17.41,均P<0.05)。乳腺癌患者血清PINP、CTX水平与Cathe K水平呈负相关(r=-0.39、-0.47),与MGP、IGFBP-3水平呈正相关(r=0.51、0.60、0.42、0.49,P<0.05);血清Cathe K、MGP、IGFBP-3、PINP、CTX预测女性乳腺癌患者术后发生骨质疏松的曲线下面积(area under the curve,AUC)分别为0.74(95%CI:0.665~0.810)、0.81(95%CI:0.733~0.865)、0.83(95%CI:0.762~0.887)、0.82(95%CI:0.749~0.878)、0.77(95%CI:0.698~0.838),血清Cathe K、MGP、IGFBP-3联合的AUC最大,为0.92(95%CI:0.86~0.96)。结论血清Cathe K、MGP、IGFBP-3水平与绝Objective To explore the value of serum cathepsin K(Cathe K),matrix gla protein(MGP)and insulin-like growth factor binding protein3(IGFBP-3)in predicting the risk of osteoporosis after radical surgery for breast cancer.Methods One hundred and fifty female breast cancer patients who completed radical breast cancer surgery and 1-year postoperative follow-up in Linyi People’s Hospital from Jun.2019 to Jun.2021 were collected as study subjects,and the incidence of osteoporosis was counted.The clinical data,bone transition markers[typeⅠprocollagenamino-terminal peptide(PINP),typeⅠcollagen carboxy-terminal peptide(CTX)],serum Cathe K,MGP and IGFBP-3 levels in patients with and without osteoporosis were compared.The correlation between serum Cathe K,MGP and IGFBP-3 levels and bone transition markers,and the value of each index in predicting the risk of osteoporosis after radical breast cancer surgery were analyzed.The value of serum Cathe K,MGP and IGFBP-3 with bone transition markers in predicting the risk of osteoporosis were compared.Results The incidence of osteoporosis after radical breast cancer surgery in 150 women with breast cancer was 34.67%(52/150).The serum Cathe K level was(31.86±9.52)ng/L in patients with osteoporosis,which was higher than(24.87±5.34)ng/L in patients without osteoporosis.The serum levels of MGP,IGFBP-3,PINP,and CTX were(8.64±1.33)ng/ml,(10.13±2.29)μg/mL,(44.13±4.87)μg/L,(0.42±0.13)μg/L,respectively,which were higher than those of patients without osteoporosis(12.39±1.71)ng/mL,(13.10±2.63)μg/mL,(93.25±29.71)μg/L and(1.65±0.50)μg/L,with statistically significant differences(t=5.77,13.75,6.88,11.82,17.41,all P<0.05).Serum PINP and CTX levels in breast cancer patients were negatively correlated with Cathe K levels(r=-0.39,-0.47),and positively correlated with MGP and IGFBP-3 levels(r=0.51,0.60,0.42,0.49,P<0.05).The area under the curve(AUC)predicted by serum Cathe K,MGP,IGFBP-3,PINP,and CTX for postoperative osteoporosis in women with breast cancer were 0.74(95%CI:0.665-0

关 键 词：乳腺癌 骨质疏松 组织蛋白酶K 基质GLA蛋白 胰岛素样生长因子结合蛋白-3 

分 类 号：R737.9[医药卫生—肿瘤]