乳腺癌患者血清抗核抗体的表达

Expression of serum antinuclear antibodies in breast cancer patients

目的了解乳腺癌患者血清抗核抗体阳性率、细胞内定位及免疫荧光图形特点,探索抗核抗体作为肿瘤标志物的可能性。方法收集2008年11月至2009年12月山东省威海市文登中心医院收治的97例女性乳腺癌,其中有腋窝淋巴结转移53例,无转移44例,52例女性乳腺良性肿瘤患者的术前血液标本,56例健康女性血液样本作为对照,应用间接免疫荧光法(IIF)检测血清中抗核抗体。统计分析用χ2检验,若P<0.05。再进行两两比较。结果抗核抗体阳性率分别为对照组16.1%(9/56),良性肿瘤组21.2%(11/52),乳腺癌未转移组45.4%(20/44),乳腺癌转移组43.4%(23/53),4组比较差异有统计学意义(χ2=16.369,P=0.001)。两两比较显示乳腺癌未转移组、乳腺癌转移组抗核抗体阳性率高于对照组(χ2=10.332,P=0.001;χ2=9.803,P=0.002)。对照组、良性肿瘤组、乳腺癌组三组间的抗核抗体、抗核质抗体阳性率比较,差异有统计学意义(χ2=16.321、7.902,P=0.000、0.019),抗胞质抗体阳性率比较差异无统计学意义(χ2=5.995,P=0.050)。乳腺癌组与对照组的抗核抗体、抗核质抗体差异有统计学意义(χ2=12.636、5.972,P=0.000、0.015),抗胞质抗体差异无统计学意义(χ2=4.473,P=0.034)。乳腺癌组与良性肿瘤组相比,抗核抗体差异有统计学意义(χ2=7.869,P=0.005),抗核质抗体、抗胞质抗体差异无统计学意义(χ2=3.829、2.514,P=0.051、0.113)。乳腺癌转移组与未转移组抗核抗体、抗核质抗体、抗胞质抗体比较,差异无统计学意义(χ2=0.041、1.607、1.861,P>0.050)。四组间血清抗核质抗体的比较差异有统计学意义(χ2=9.900,P=0.019)。结论乳腺癌患者血清的抗核抗体与健康人生理性抗核抗体不同,有助于深入认识乳腺癌患者自身免疫现象,以供临床参考。

Objective To investigate the positive rate, intracellular localization and immunofluorescent characteristics of serum antinuclear antibodies in breast cancer patients, and to explore the possibility of anti- nuclear antibody as tumor markers. Methods From November 2008 to December 2009, preoperative blood samples were collected from 97 breast cancer women, including 53 patients with axillary lymph node metastasis and 44 with no metastasis, and 52 women with benign breast tumor, and 56 healthy women served as control. Indirect immunofluorescence was used to detect the antinuclear antibodies in serum. The data were analyzed by chi-square test. If P〉 0. 05, pairwise comparison was conducted. Results The positive rate of antinuclear antibody was 16. 1% （9/56） in the control group, 21.2% （11/52） in benign tumor group, 45.4% （20/40） in non-metastatic breast cancer group, 43.4% （23/53） in metastatic breast cancer group. The difference among the 4 groups was statistically significant （ X2 = 16. 369, P = 0. 001 ）. Pairwise comparison showed the positive rate of antinuclear antibody in non-metastatic breast cancer group and metastatic breast cancer group was higher than that in control group （X2 = 10. 332, P=0. 001 ; X2 =9. 803, P=0. 002）. Among control group, benign tumor and breast cancer group, statistically significant difference was found in the positive rates ofantinuclear antibodies （ X2 = 16. 321, P= O. 000 ） and anti-nucleoplasmic antibodies （ X2 = 7. 902, P = O. 019 ）, but not in the positive rate of anti-cytoplasmic antibodies （ X2 = 5. 995, P = 0. 050 ）. Comparing breast cancer group and the control group, statistically significant difference was found in antinuclear antibodies and anti- nucleoplasmic antibodies （ X2 = 12. 636,5. 972, P = 0. 000,0. 015 ）, but not in anti-cytoplasmic antibodies （ X2 = 4. 473, P = 0. 034 ） . Comparing breast cancer group and the benign tumor group, statistically significant difference was found in antinuclear antibodies （X2 = 7. 869, P = 0. 005 ）, but not in anti-nueleoplasmic and anti- cytoplasmic antibodies （ X2 = 3. 829, 2. 514, P = 0. 051, 0. 113 ）. There was no statistically significant difference in the antinuclear, anti-nucleoplasmic, anti-cytoplasmic antibodies between non-metastatic breast cancer and metastatic breast cancer patients （ X2 = 0. 041, 1. 607, 1. 861, P 〉 0. 050 ）. Anti-nucleoplasmic antibodies showed no statistical difference among the four groups （X2= 9. 900, P = 0. 019 ）. Conclusion The serum anti-nuclear antibodies in breast cancer patients are substantially different from those in the healthy population, which provides a better understanding of autoimmunity of breast cancer patients for clinical diagnosis.