摘要
目的探讨血清Ⅳ型胶原蛋白α3(COL4A3)、Ⅹ型胶原蛋白(COL10)A1与乳腺癌改良根治术后复发转移的关系。方法选取2016年1月至2018年1月在平顶山市第二人民医院诊断为乳腺癌并计划行改良根治术治疗的患者共163例为研究对象,术前检测血清COL4A3、COL10A1水平,术后随访5 a统计复发转移情况。分析影响乳腺癌改良根治术后复发转移的相关因素以及COL4A3、COL10A1预测乳腺癌改良根治术后复发转移价值。结果随访5 a,期间失访4例,复发转移50例,复发转移率31.45%,复发转移组TNM分期Ⅱ期、腋窝淋巴结转移个数≥5个、术后未进行内分泌治疗和术后未进行辅助放疗比率、血清COL10A1水平高于无复发转移组(P<0.05),血清COL4A3水平低于无复发转移组(P<0.05),两组肿瘤直径比较差异有统计学意义(P<0.05)。多因素Cox回归分析显示腋窝淋巴结转移个数≥5个、高水平COL10A1是乳腺癌改良根治术后复发转移的危险因素(P<0.05),高水平COL4A3是保护因素(P<0.05)。COL4A3、COL10A1预测乳腺癌改良根治术后复发转移的临界值分别为3.26、4.27μg·L^(-1),曲线下面积分别为0.695、0.717,联合预测的曲线下面积为0.863,高于单独预测。结论血清COL4A3、COL10A1水平增高与乳腺癌改良根治术后复发转移有关,联合COL4A3、COL10A1可提高对乳腺癌改良根治术后复发转移的预测价值。
Objective To investigate the relationship between serum typeⅣcollagenα3(COL4A3),typeⅩcollagen(COL10)A1 and recurrence and metastasis after modified radical operation for breast cancer.Methods A total of 163 patients who were diagnosed with breast cancer and planned to undergo modified radical operation in the Second People’s Hospital of Pingdingshan City from January 2016 to January 2018 were selected as study subjects,the levels of serum COL4A3 and COL10A1 were detected before operation,and the recurrence and metastasis were counted after 5 years of follow up.The related factors affecting the recurrence and metastasis of breast cancer after modified radical operation the value of COL4A3 and COL10A1 in predicting recurrence and metastasis of breast cancer after modified radical operation were analyzed.Results During the 5 years follow up,4 cases were lost to follow up,50 cases had recurrence and metastasis,and the recurrence and metastasis rate was 31.45%.TNM stage Ⅱ,number of axillary lymph node metastasis≥5,no endocrine therapy after operation and no adjuvant radiotherapy after operation,and the serum COL10A1 level in recurrence and metastasis group were higher than that in no recurrence and metastasis group(P<0.05),and the serum COL4A3 level was lower than that in no recurrence and metastasis group(P<0.05),there was a statistically significant difference in tumor diameter between two groups(P<0.05).Multivariate Cox regression analysis showed that the number of axillary lymph node metastasis≥5,high level of COL10A1 were risk factors for recurrence and metastasis of breast cancer after modified radical operation(P<0.05),and high level of COL4A3 was a protective factor(P<0.05).The critical values of COL4A3 and COL10A1 for predicting recurrence and metastasis of breast cancer after modified radical operation were 3.26 and 4.27μg·L^(-1) respectively,and the area under the curve was 0.695 and 0.717 respectively.The area under the curve predicted by COL4A3 and COL10A1 was 0.863,which was higher than th
作者
典辉
何明长
崔路洗
DIAN Hui;HE Mingchang;CUI Luxi(Department of General Surgery,the Second People’s Hospital of Pingdingshan City,Pingdingshan 467000,China)
出处
《河南医学研究》
2023年第23期4328-4332,共5页
Henan Medical Research
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210835)。
