基线血清VEGF水平对非三阴性乳腺癌患者临床因素、病理特征及预后的影响  

Effect of baseline serum VEGF level on clinical factors,pathological features and prognosis of patients with non-triple-negative breast cancer

作　　者：鲜童丞 张雪琳 别俊[2] 杨闽叶 王杰[1] 罗义 XIAN Tongcheng;ZHANG Xuelin;BIE Jun;YANG Minye;WANG Jie;LUO Yi(Department of Thyroid and Breast Surgery,the Nanchong City Central Hospital Affiliated to North Sichuan Medical College,Nanchong,Sichuan 637000,China;Department of Oncology,the Nanchong City Central Hospital Affiliated to North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院附属南充市中心医院甲状腺乳腺外科,四川南充637000 [2]川北医学院附属南充市中心医院肿瘤科,四川南充637000

出　　处：《国际检验医学杂志》2024年第15期1849-1855,共7页International Journal of Laboratory Medicine

基　　金：四川省科技计划项目(2023YFS0473)。

摘　　要：目的分析基线血清血管内皮生长因子(VEGF)水平对非三阴性乳腺癌患者临床因素、病理特征及预后的影响。方法选取2019年1月至2020年12月该院收治的非三阴性乳腺癌患者120例作为研究对象,根据肿瘤TNM分期,将研究对象分别分为TNM分期Ⅰ、Ⅱ期乳腺癌患者80例(A组)和TNM分期Ⅲ期乳腺癌患者40例(B组),比较两组患者血清VEGF水平、临床因素和病理特征。采用受试者工作特征(ROC)曲线分析血清VEGF水平预测乳腺癌Ⅲ期的最佳截断值,采用Kaplan-Meier法绘制总生存率、无病生存率的生存曲线,比较采用Log-rank检验。基线血清VEGF水平对非三阴性乳腺癌总生存率及无病生存率的影响采用多因素Cox回归模型。结果B组血清VEGF、D-二聚体、纤维蛋白原(FIB)、纤维蛋白降解产物(FDP)、癌抗原125(CA-125)和癌抗原15-3(CA15-3)与A组比较,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,非三阴性乳腺癌TNM分期Ⅲ期的血清VEGF的曲线下面积为0.875,95%CI(0.802~0.948),P<0.001。血清VEGF≥180.40 pg/mL患者的D-二聚体、FIB、FDP水平、CA-125、CA15-3水平高于血清VEGF<180.40 pg/mL患者,差异有统计学意义(P<0.05)。血清VEGF<180.40 pg/mL患者肿瘤T1分期、肿瘤N0、N1分期、TNM分期Ⅰ/Ⅱ期、Luminal A型占比高于血清VEGF≥180.40 pg/mL患者,差异有统计学意义(P<0.05)。血清VEGF<180.40 pg/mL患者的无病生存率明显高于血清VEGF≥180.40 pg/mL患者,差异有统计学意义(P<0.001)。矫正各项指标后,VEGF≥180.40 pg/mL为非三阴性乳腺癌复发转移的危险因素[HR=2.563,95%CI(1.772~3.708),P<0.001]。结论高基线VEGF水平与非三阴性乳腺癌进展有关,是其预后的影响因素。Objective To analyse the effect of baseline serum vascular endothelial growth factor(VEGF)level on clinical factors,pathological features and prognosis of patients with non-triple-negative breast cancer.Methods A total of 120 patients with non-triple-negative breast cancer admitted to the hospital from January 2019 to December 2020 were selected as the study objects.According to the TNM stage of the tumor,the study objects were divided into 80 patients with TNM stageⅠandⅡ(group A)and 40 patients with TNM stageⅢ(group B).Serum VEGF levels,clinical factors and pathological features were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the optimal cut-off value of serum VEGF level in predicting stageⅢbreast cancer.Survival curves for overall survival and disease-free survival were plotted using the Kaplan-Meier method,and comparisons were made using the Log-rank test.The effects of baseline serum VEGF levels on overall survival and disease-free survival in non-triple-negative breast cancer were investigated by multivariate Cox regression model.Results Serum VEGF,D-dimer,fibrinogen(FIB),fibrin degradation products(FDP),cancer antigen 125(CA-125)and cancer antigen 15-3(CA15-3)in group B were significantly different from those in group A(P<0.05).ROC curve analysis showed that the area under the curve of serum VEGF in TNM stageⅢof non-triple-negative breast cancer was 0.875,95%CI(0.802-0.948),P<0.001.The levels of D-dimer,FIB,FDP,CA-125 and CA15-3 in serum VEGF≥180.40 pg/mL patients were higher than those in serum VEGF<180.40 pg/mL patients,and the differences were statistically significant(P<0.05).In patients with serum VEGF<180.40 pg/mL,the proportion of tumor T1 stage,tumor N0 and N1 stage,TNM stageⅠ/Ⅱ,and Luminal type A were higher than those with serum VEGF≥180.40 pg/mL patients,and the differences were statistically significant(P<0.05).The disease-free survival rate of serum VEGF<180.40 pg/mL patients was significantly higher than that of serum VEGF�

关 键 词：非三阴性乳腺癌 血管内皮生长因子 病理特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]