乳腺癌患者4种不同指标变化及其与病理参数的关系  

Changes in four different indicators and their relationships with pathological parameters in breast cancer patients

作　　者：汪倩倩[1] 董雨萍 严丽洁[1] 王水[1] WANG Qianqian;DONG Yuping;YAN Lijie;WANG Shui(General Surgery Department,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029;Dujiangyan People′s Hospital of Sichuan Province,Chengdu,Sichuan,611830)

机构地区：[1]南京医科大学第一附属医院普外科,江苏南京210029 [2]四川省都江堰市人民医院,四川成都611830

出　　处：《实用临床医药杂志》2024年第20期1-5,共5页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金项目(82172683)。

摘　　要：目的分析乳腺癌患者辅助性T细胞17与调节性T细胞的比值(Th17/Treg)、铁蛋白(SF)、微小核糖核酸-145(miR-145)、微小核糖核酸-132(miR-132)变化及其与病理参数的关系。方法选取2022年1月—2023年12月92例乳腺癌患者为研究组,并选取同期乳腺良性疾病患者105例为对照组。比较2组SF、miR-132、Th17/Treg、miR-145的变化情况,并分析上述各指标对乳腺癌的诊断价值。结果与对照组比较,研究组外周血Th17/Treg、血清SF水平均更高,血清miR-145、miR-132表达水平更低,差异有统计学意义(P<0.05)。与肿瘤直径≤2 cm、临床分期为Ⅰ~Ⅱ期、肿瘤高分化、不存在淋巴结转移的患者比较,肿瘤直径>2 cm、临床分期为Ⅲ~Ⅳ期、肿瘤中低分化、存在淋巴结转移患者的血清miR-145、miR-132表达水平均更低,差异有统计学意义(P<0.05)。与临床分期为Ⅰ~Ⅱ期、肿瘤高分化、不存在淋巴结转移的患者比较,临床分期为Ⅲ~Ⅳ期、肿瘤中低分化、存在淋巴结转移患者的血清SF水平均更高,差异有统计学意义(P<0.05)。与不存在淋巴结转移的患者比较,存在淋巴结转移的患者的Th17/Treg更高,差异有统计学意义(P<0.05)。乳腺癌患者Th17/Treg、SF、miR-145、miR-132水平联合检测的曲线下面积(AUC)大于单独检测(P<0.05),敏感度、特异度均更高。结论Th17/Treg、SF、miR-145、miR-132在乳腺癌患者血液中均呈异常表达,与患者的病理参数均存在一定关系,且四者联合检测在乳腺癌的临床诊断中具有更高的价值。Objective To analyze the changes in the ratio of helper T cell 17 to regulatory T cells(Th17/Treg),serum ferritin(SF),microRNA-145(miR-145),and microRNA-132(miR-132)levels in breast cancer patients and their relationships with pathological parameters.Methods A total of 92 breast cancer patients from January 2022 to December 2023 were enrolled as study group,and 105 patients with benign breast diseases during the same period were selected as control group.Changes in SF,miR-132,Th17/Treg,and miR-145 were compared between the two groups,and the diagnostic value of these indicators for breast cancer was analyzed.Results Compared with the control group,the study group had higher peripheral blood Th17/Treg and serum SF levels,and lower serum miR-145 and miR-132 expression levels(P<0.05).Patients with tumor diameters>2 cm,clinical stages ofⅢtoⅣ,moderately or poorly differentiated tumors,and lymph node metastasis had lower serum miR-145 and miR-132 expression levels than those with tumor diameters≤2 cm,clinical stages ofⅠtoⅡ,highly differentiated tumor,and no lymph node metastasis(P<0.05).Compared with patients with clinical stages ofⅠtoⅡ,highly differentiated tumors,and no lymph node metastasis,those with clinical stages ofⅢtoⅣ,moderately or poorly differentiated tumors,and lymph node metastasis had higher serum SF levels(P<0.05).Patients with lymph node metastasis had higher Th17/Treg levels than those without(P<0.05).The area under the curve(AUC)for combined detection of Th17/Treg,SF,miR-145,and miR-132 levels in breast cancer patients was higher than that for individual detection(P<0.05),with higher sensitivity and specificity.Conclusion Th17/Treg,SF,miR-145,and miR-132 are abnormally expressed in the blood of breast cancer patients and are correlated with their pathological parameters.Combined detection of these four indicators has higher value in the clinical diagnosis of breast cancer.

关 键 词：乳腺癌 辅助性T细胞17 调节性T细胞 铁蛋白 微小核糖核酸-145 微小核糖核酸-132 病理参数 

分 类 号：R737.9[医药卫生—肿瘤] R446[医药卫生—临床医学] R392.12