血管生成素样蛋白2在乳腺癌组织与血清中的表达及临床意义

Clinical significance of Angptl2 expression in tumor tissue and serum in patients with breast cancer

目的：分析血管生成素样蛋白2（angiopoietin-like protein 2，Angptl2）在乳腺癌组织和血清中的表达。方法乳腺癌和癌旁组织蜡块78例，免疫组化法检测患者术前与术后血清Angptl2蛋白的表达，酶联免疫吸附试验法（ELISA）检测患者血清 Angptl2水平，并分析 Angptl2蛋白的表达与临床病理特征及无进展生存（ progression-free survival，PFS）的关系。受试者特征（ the receiver operating characteristics，ROC）曲线分析血清 Angptl2诊断乳腺癌的敏感性与特异性。结果乳腺癌组织标本中，Angptl2表达阳性64例（82.1％），其中，Angptl2高/中表达在癌组织和癌旁组织分别为42例（53.8％）和6例（7.7％）（P ﹤0.01）。Angptl2高/中表达与患者淋巴结转移有关，并导致 PFS 缩短。乳腺癌患者血清中 Angptl2水平为（218.72±88.02）ng/ ml，对照组为（80.88±30.59）ng/ ml，两组比较差异有统计学意义（P ﹤0.01）。曲线下面积（area under the curve，AUC）为0.909，诊断效能良好。术后1周 Angptl2水平下降至（142.43±60.29）ng/ ml，但仍高于对照组，较差异有统计学意义（P ﹤0.01）。结论乳腺癌患者癌组织和血清中 Angptl2表达均升高，Angptl2可作为乳腺癌早期诊断与预后判断的标志物。

Objective To explore Angptl2（angiopoietin-like protein 2）expression in tumor tis-sue and serum in patients with breast cancer（BC）. Methods A total of 78 BC patients were enrolled in this study. Immunohistochemistry was used to detect Angptl2 expression in tumor and adjacent normal tis-sues. Preoperative and postoperative serum Angptl2 levels were determined via ELISA. Correlation among Angptl2 expression,clinicopathological factors and progression-free survival（PFS）were further evalua-ted. The receiver operating characteristics（ROC）curve was constructed to describe diagnostic specificity and sensitivity. Results Angptl2 was positively expressed in 64（82. 1% ）cases. The rates of high and moderate expression of Angpt l2 in tumor and adjacent tissues were 53. 8%（42 / 78）and 7. 7%（6 / 78）, respectively（P﹤0. 001）. Moreover,the elevated Angptl2 protein was significantly associated with lymph metastasis and adverse PFS. In addition,serum Angptl2 level in BC patients was significantly higher than that in benign controls[（218. 72 ± 88. 02）vs（80. 88 ± 30. 59）ng/ ml,P ﹤ 0. 01]. The area under the curve（AUC）was 0. 909,which indicated a good function for diagnosis. Postoperative serum Angptl2 level was decreased to（142. 43 ± 60. 29）ng/ ml,but still higher than that in controls（P ﹤ 0. 01）. Conclusion The expression of Angptl2 may increase in tumor tissue and serum of BC and it may be a potential tumor marker for diagnosis and prognosis.