乳腺癌骨转移患者血清肿瘤标志物的表达及意义

张维; 刘辉; 姜俊杰; 贾正艳; 王文杰; 杨云云

doi:10.7619/jcmp.20220946

乳腺癌骨转移患者血清肿瘤标志物的表达及意义

Expression and significance of serum tumor markers in patients with bone metastasis of breast cancer

摘要

摘要:
目的探讨乳腺癌骨转移患者血清白细胞介素-6(IL-6)、血清碱性磷酸酶(ALP)、血清Ⅰ型胶原氨基末端肽(NTx)、Ⅰ型胶原羧基端肽(ICTP)表达水平及其诊断骨转移发生的价值。
方法将172例乳腺癌患者依据全身骨显像结果及判断标准分为骨转移组79例和非骨转移组93例。检测2组患者血清中IL-6、ALP、NTx、ICTP水平; 采用受试者工作特征(ROC)曲线分析血清IL-6、ALP、NTx、ICTP水平诊断乳腺癌患者发生骨转移的价值; 采用Logistic回归模型分析乳腺癌患者发生骨转移的危险因素。
结果骨转移组中原发肿瘤直径>5 cm、有淋巴结转移、组织学分级为Ⅲ级患者的比率高于无骨转移组, 差异有统计学意义(P < 0.05或P < 0.01)。骨转移组患者血清IL-6、ALP、NTx、ICTP水平均高于无骨转移组患者，差异有统计学意义(P < 0.05)。血清IL-6、ALP、NTx、ICTP水平诊断乳腺癌患者发生骨转移的ROC曲线的曲线下面积分别为0.646、0.681、0.663、0.657。淋巴结转移、血清ALP水平升高、血清NTx水平升高是乳腺癌患者发生骨转移的危险因素(P < 0.05)。
结论乳腺癌骨转移患者血清IL-6、ALP、NTx、ICTP水平均显著升高。血清IL-6、ALP、NTx、ICTP水平对乳腺癌患者发生骨转移具有一定的诊断效能，有望作为诊断乳腺癌患者发生骨转移的潜在血清标志物。

Abstract:
Objective To investigate the expression levels of serum interleukin-6 (IL-6), serum alkaline phosphatase (ALP), serum N-telopeptide of type Ⅰ collagen (NTx) and pyridinoline-cross-linked carboxyterminal telopeptide of typeⅠcollagen (ICTP) in patients with bone metastases of breast cancer and their values in diagnosing the occurrence of bone metastases.
Methods A total of 172 patients with breast cancer were divided into bone metastasis group (n=79) and non-bone metastasis group (n=93) according to the results of whole-body bone imaging and judgment criteria. The levels of IL-6, ALP, NTx and ICTP in serum were detected in both groups; the receiver operating characteristic (ROC) curve was used to analyze values of serum IL-6, ALP, NTx and ICTP levels in the diagnosis of patients with bone metastasis of breast cancer; Logistic regression model was used to analyze the risk factors of bone metastasis in breast cancer patients.
Results The proportions of patients with primary tumor diameter larger than 5 cm, lymph node metastasis and grade Ⅲ of histological grading in the bone metastasis group were significantly higher than those in the non-bone metastasis group (P < 0.05 or P < 0.01). The serum levels of IL-6, ALP, NTx and ICTP in the bone metastasis group were significantly higher than those in the non-bone metastasis group (P < 0.05). The areas under the curve of ROC curve in diagnosing bone metastasis of breast cancer by serum IL-6, ALP, NTx and ICTP levels were 0.646, 0.681, 0.663, 0.657, respectively. Lymph node metastasis, increased serum ALP and NTx levels were the risk factors for bone metastasis in patients with breast cancer (P < 0.05).
Conclusion Serum IL-6, ALP, NTx and ICTP levels in patients with bone metastasis of breast cancer are significantly increased. Serum IL-6, ALP, NTx and ICTP levels have certain diagnostic efficiencies for bone metastasis in patients with breast cancer, which are expected to be the potential serum markers for bone metastasis in patients with breast cancer.

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