乳腺癌患者血清TGF-β1、VEGF及肿瘤标志物水平与保乳术后局部复发的关系  

Relationship between serum levels of TGF-β1,VEGF and tumor markers and local recurrence after breast-conserving surgery in patients with breast cancer

作　　者：李守帅[1] 赵戈 田立民[1] 朱海军 Li Shoushuai;Zhao Ge;Tian Limin;Zhu Haijun(Department of General Surgery,Xi’an Central Hospital,Xi’an 710000,China;Department of Thyroid and Breast Vascular Surgery,the First Affiliated Hospital of Air Force Military Medical University,Xi’an 710032,China)

机构地区：[1]西安市中心医院普外三科,西安710000 [2]中国人民解放军空军军医大学第一附属医院甲乳血管外科,西安710032

出　　处：《中华内分泌外科杂志（中英文）》2024年第5期619-623,共5页Chinese Journal of Endocrine Surgery

基　　金：陕西省自然科学基础研究计划一般项目(2020JM-340)。

摘　　要：目的探究乳腺癌患者血清转化生长因子-β1(transforming growth factor-β1,TGF-β1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)及肿瘤标志物水平与保乳术后局部复发的关系。方法选取2020年1月至2022年12月于西安市中心医院行保乳术的104例乳腺癌患者,术后随访1年,根据局部复发情况分为复发组(n=16)和未复发组(n=88),比较两组患者血清TGF-β1、VEGF及肿瘤标志物[糖类抗原125(carbohydrate antigen 125,CA125)、癌胚抗原(carcinoembryonic antigen,CEA)]水平,采用单因素及多因素Logistic回归分析保乳术后局部复发的影响因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析TGF-β1、VEGF、CAl25及CEA对保乳术后局部复发的预测价值。结果复发组VEGF为(358.83±38.00)ng/L、TGF-β1为(849.90±74.19)U/mL、CA125为(18.34±1.61)ng/L及CEA为(40.20±5.64)ng/mL,均高于未复发组的(296.05±39.57)ng/L、(742.85±79.96)ng/L、(14.97±1.66)U/mL、(32.79±4.72)ng/mL(P均<0.05);淋巴转移、术后辅助治疗、肿瘤直径、TNM分期是保乳术后局部复发的独立危险因素(P均<0.05);血清VEGF、TGF-β1、CAl25及CEA预测保乳术后局部复发的ROC曲线下面积(areas under the ROC curves,AUC)分别为0.847、0.834、0.925、0.935,其中CEA的AUC最大,敏感度为85.23%,特异度为100%(P均<0.05)。结论保乳术后局部复发患者体内TGF-β1、VEGF、CA125及CEA水平升高,其水平对保乳术后局部复发预测效能较高,且保乳术后局部复发还受淋巴转移、术后辅助治疗、肿瘤直径、TNM分期影响。ObjectiveTo explore the relationship between serum levels of transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF)and tumor markers and local recurrence after breast-conserving surgery in patients with breast cancer.Methods104 patients with breast cancer who underwent breast-conserving surgery in Xi’an Central Hospital from Jan.2020 to Dec.2022 were selected and followed up for 1 year after surgery.According to the occurrence of local recurrence,they were divided into recurrence group(n=16)and non-recurrence group(n=88).The levels of serum TGF-β1,VEGF and tumor markers[carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)]were compared between the two groups of patients.Univariate and multivariate Logistic regression analyses were used to analyze the influencing factors of local recurrence after breast-conserving surgery.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of TGF-β1,VEGF,CA125 and CEA on local recurrence after breast-conserving surgery.ResultsThe levels of VEGF,TGF-β1,CAl25 and CEA in recurrence group[(358.83±38.00)ng/L,(849.90±74.19)U/mL,(18.34±1.61)ng/L and(40.20±5.64)ng/mL]were higher than those of(296.05±39.57)ng/L(742.85±79.96)ng/L,(14.97±1.66)U/mL and(32.79±4.72)ng/mL in non-recurrence group(all P<0.05).Lymph node metastasis,postoperative adjuvant therapy,tumor diameter and TNM staging were independent risk factors of local recurrence after breast-conserving surgery(all P<0.05).The areas under the ROC curves(AUCs)of serum VEGF,TGF-β1,CAl25 and CEA in predicting local recurrence after breast-conserving surgery were 0.847,0.834,0.925 and 0.935 respectively.The AUC of CEA was the largest,with sensitivity of 85.23%and specificity of 100%(all P<0.05).ConclusionsThe levels of TGF-β1,VEGF,CAl25 and CEA in patients with local recurrence after breast-conserving surgery are increased,and their levels are more effective in predicting local recurrence after breast-conserving surgery.Local recurrence after breast-conser

关 键 词：乳腺癌 保乳术 局部复发 转化生长因子-Β1 血管内皮生长因子 肿瘤标志物 

分 类 号：R737.9[医药卫生—肿瘤]