乳腺疾病患者血清中肿瘤标志物、细胞因子及唾液酸水平的变化及临床意义

Changes and Clinical Significances of Serum Tumor Markers, Cytokines and Sialic Acid of Patients with Breast Disease

目的:探讨乳腺疾病患者血清肿瘤标志物、细胞因子及唾液酸(Sialic acid,SA)水平的变化及临床意义。方法:选择2014年1月至2015年12月本院收治的乳腺疾病患者136例,包括乳腺癌患者(乳腺癌组)81例、良性乳腺疾病患者(良性组)55例,另选同期在本院体检的健康女性(对照组)50例,分别检测3组研究对象的血清肿瘤标志物[Carcino-embryonic antigen(CEA)、Carbohydrate antigen(CA)125、CA153、Tumor Supplied Group of Factors(TSGF)]、血清细胞因子[Vascular endothelial growth factor(VEGF)、Transforming growth factor-β(TGF-β)1]及血清SA水平。结果:(1)乳腺癌组血清CEA[(23.12±10.04)μg/L]、CA153[(57.63±18.55)U/m L]、CA125[(48.50±16.44)U/m L]、TSGF[(93.25±15.65)U/m L]、VEGF[(136.80±14.95)ng/L]、TGF-β1[(107.29±13.85)ng/L]及SA[(863.40±132.48)mg/L]水平均显著高于良性组和对照组(P<0.05);良性组血清VEGF水平显著高于对照组(P<0.05),其余指标与对照组比较差异无统计学意义(P>0.05)。(2)乳腺癌Ⅲ期和Ⅳ期患者血清CEA、CA153、CA125、TSGF、VEGF、TGF-β1及SA水平均明显高于Ⅰ期和Ⅱ期乳腺癌患者(P<0.05);其中乳腺癌Ⅰ期患者血清TSGF、VEGF及TGF-β1水平均明显低于Ⅱ期乳腺癌患者(P<0.05)。(3)乳腺癌患者治疗后3个月且无转移复发者血清CEA、CA153、CA125、TSGF、VEGF、TGF-β1及SA水平均显著低于治疗前(P<0.05);转移复发者治疗后各观察指标水平无明显降低或反升。结论:血清肿瘤标志物、血清细胞因子及血清SA水平联合检测有助于鉴别诊断乳腺良、恶性疾病,其中血清TSGF、VEGF及TGF-β1检测对乳腺癌的早期诊断、病情评价及预后具有重要的参考价值。

Objective： To investigate the changes and clinical significances of tumor markers, cytokines and sialic acid （SA） in the serum of patients with breast disease. Methods： 136 cases of patients with breast disease including 81 cases of breast cancer （cancer group） and 55 cases of benign breast （benign group） diseases were selected from January 2014 and December 2015 in our hospital. In the same period, 50 cases of healthy females （control group） were selected as the healthy control group. The tumor markers [Care^no-embry- onic antigen （CEA）, Carbohydrate antigen （CA） 125, CA153, Tumor Supplied Group of Factors （TSGF）], eytokines [Vascular endothelial growth factor （VEGF）, Transforming growth factor-β （TGF-β） 1] and SA levels in serum of 3 groups were detected and compared. Results： The levels of serum CEA [（23.12± 10.04）μg/L], CA153 [（57.63±18.55） U/mL], CA125 [（48.50±16.44） U/mL], TSGF [93.25± 15.65） U/mL], VEGF [（136.80±14.95） ng/L], TGF-β1 [（107.29±13.85） mg/L] and SA [（863.40±132.48） mg/L] in the cancer group were significantly higher than those of the benign group and control group （P 〈0.05）. Compared with the control group, the level of VEGF in the benign group was obviously higher （P 〈 0.05）, but no significant difference of the other observation indexes was found between the two groups （P〉0.05）. The levels of serum CEA, CA153, CA125, TSGF, VEGF, TGF-β1and SA levels in the stage Ⅲ and stage Ⅳof breast cancer were greatly higher than those in the stage Ⅰ and stage Ⅱ （P〈0.05）; the levels ofTSGF, VEGF and TGF-β1 in the stage Ⅰ of breast cancer were obviously lower than those of the stage Ⅱ （P〈0.05）. Compared with the breast cancer patients before treatment, the levels of CEA, CA153, CA125, TSGF, VEGF, TGF-β1 and SA of patients without metastatic recurrence after treatment were obviously lower （P〈0.05）. However, the levels of all the observation indexes of patients with metastatic recurrence after treatment hadn＇t decreased and even increased. Conclusion： Combined detection of serum tumor markers, eytokines and sialic acid were useful for diagnosing benign and malignant breast diseases. And the detection of TSGF, VEGF and TGF-β1 provided important references on the early diagnosis, condition assessment and prognostic prediction of breast disease.