乳腺癌保乳术后放疗患者血常规指标、肿瘤标志物及趋化因子水平变化对癌症复发的预测价值  

Changes of blood routine indexes,tumor markers and chemokines in breast cancer patients after radiotherapy and their predictive value for cancer recurrence

作　　者：桑娟[1] 岳雯[1] 刘海凤 张泽高[1] Sang Juan;Yue Wen;Liu Haifeng;Zhang Zegao(Radiotherapy Center of Xinjiang Uygur Autonomous Region People's Hospital,Xinjiang,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院放疗中心,乌鲁木齐830001

出　　处：《疑难病杂志》2025年第3期309-312,317,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金资助项目(2020D01C321)。

摘　　要：目的探讨保乳术后放疗的乳腺癌患者血常规指标、肿瘤标志物及趋化因子水平变化及对癌症复发的预测价值。方法选取2020年4月-2022年5月新疆维吾尔自治区人民医院放疗中心诊治乳腺癌患者102例作为研究对象,所有患者均接受保乳手术治疗及术后辅助放疗。根据放疗后1年内癌症复发情况分为未复发组(n=80)和复发组(n=22)。比较2组患者血常规指标[中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、单核细胞/淋巴细胞比值(MLR)]、肿瘤标志物[糖类抗原(CA)-125、CA153、CA199、癌胚抗原(CEA)]及趋化因子水平[CC趋化因子配体(CCL)2、CCL8、CCL21]的差异;Spearman相关性分析差异性指标与术后放疗乳腺癌患者癌症复发的相关性;多因素Logistic回归分析筛选术后放疗的乳腺癌患者癌症复发的危险因素。结果复发组患者NLR、PLR及MLR水平均高于未复发组患者(t/P=4.274/<0.001、3.386/0.001、4.983/<0.001)。2组CA125、CA153、CA199及CEA水平比较差异均无统计学意义(P>0.05);复发组CCL8、CCL21水平均高于未复发组(t/P=4.529/<0.001、4.480/<0.001)。Spearman相关性分析表明乳腺癌术后放疗患者TNM分期、NLR、PLR、MLR、CCL8及CCL21水平与癌症复发呈显著正相关(r/P=0.211/0.033、0.420/<0.001、0.322/0.001、0.382/<0.001、0.436/<0.001、0.393/<0.001)。多因素Logistic回归分析发现患者NLR、PLR、MLR、CCL8及CCL21水平较高均是癌症复发的危险因素[OR(95%CI)=3.579(1.397~9.140)、1.043(1.003~1.084)、3.113(1.330~9.168)、1.061(1.015~1.109)、1.032(1.002~1.174)]。结论保乳手术后放疗乳腺癌患者NLR、PLR、MLR、CCL8及CCL21水平较高与癌症复发密切相关,监测乳腺癌患者上述指标对于辅助预测癌症复发具有一定临床价值。Objective To investigate the changes of blood routine indexes,tumor markers and chemokines in breast cancer patients after radiotherapy and their predictive value for cancer recurrence.Methods One hundred and two patients with breast cancer from our hospital were enrolled in this study from April 2020 to May 2022.All patients received breast-conserving surgery and postoperative adjuvant radiotherapy,and were divided into non-recurrence group(n=80)and recurrence group(n=22)according to the recurrence within one year after radiotherapy.General clinical data[age,body mass index(BMI),diabetes history,hypertension history,TNM stage,tumor size,course of disease,location of cancer,pathological type],blood routine indicators[neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),monocyte/lymphocyte ratio(MLR)],tumor markers[carbohydrate antigen(CA)-125,CA153,CA199,carcinoembryonic antigen(CEA)]and chemokines[CC chemokine ligand(CCL)-2,CCL-8,CCL-21]were compared between the groups.Spearman correlation analysis and multivariate Logistic regression analysis were used to screen the risk factors of cancer recurrence in breast cancer patients after radiotherapy.Results The mean NLR,PLR and MLR levels in relapsed group were significantly higher than those in non-relapsed group(t/P=4.274/<0.001,3.386/<0.001,4.983/<0.001).There were no significant differences in average CA125,CA153,CA199 and CEA levels between the two groups(P>0.05).The CCL8 and CCL21 levels were significantly higher than those in non-relapse group(t/P=4.529/<0.001,4.480/<0.001).Spearman correlation analysis showed that TNM grade,NLR,PLR,MLR,CCL8 and CCL21 levels were significantly positively correlated with cancer recurrence(r/P=0.211/0.033,0.420/<0.001,0.322/0.001,0.382/<0.001,0.436/<0.001,0.393/<0.001).Multivariate Logistic regression analysis showed that higher levels of NLR,PLR,MLR,CCL8 and CCL21 were risk factors for cancer recurrence[OR(95%CI)=3.579(1.397-9.140),1.043(1.003-1.084),3.113(1.330-9.168),1.061(1.015-1.109),1.032(1.002-1.174)].Conclusio

关 键 词：乳腺癌 保乳手术 术后放疗 趋化因子 癌症复发 

分 类 号：R737.9[医药卫生—肿瘤]