乳腺癌根治术后心肌损伤标志物与临床病理的关系研究

A study on relationship between myocardial injury markers and clinicopathology after radical mastectomy

目的研究乳腺癌根治术后心肌酶谱、肌红蛋白(Mb)、肌钙蛋白I(cTnI)水平与肿瘤临床病理特征的关系。方法选取医院收治的85例行乳腺癌根治术患者为研究对象,根据肿瘤直径、组织学分级、淋巴结转移、雌孕激素受体情况对患者进行分组,比较各组间乳腺癌根治术后1 d肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天门冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)和Mb、cTnI水平的变化。结果各组间术后CK、CK-MB、AST、LDH、Mb水平比较,肿瘤直径T1组(≤2.0 cm)显著低于T2组(2.1~5.0 cm)和T3组(>5.0 cm)(P<0.05),T2组又显著低于T3组(P<0.05);组织学分级Ⅰ级组显著低于Ⅱ级和Ⅲ级(P<0.05),Ⅱ级又显著低于Ⅲ级(P<0.05);淋巴结未转移组显著低于转移组(P<0.05);雌/孕激素受体阳性组显著低于阴性组(P<0.05)。结论乳腺癌根治术后,心脏事件的发生与肿瘤直径、组织学分级、淋巴结转移、雌孕激素受体等肿瘤临床病理特征存在一定联系。

Objec t ive To study the relationship between the levels of myocardial enzyme, myoglobin （Mb） and cardiac troponin （cTnl） and the clinicopathologic features of tumor. MeAods A total of 85 patients who had undergone radical mastectomy and had been admitted to our hospital were selected for this study and were divided into groups according to the tumor diameter, histological grade, lymphatic metastasis and status of estrogen and progestogen receptors, and the changes in the levels of creatine kinase （CK）, creatine kinase isoenzyme （CK-MB）, aspartic aminotransferase （AST）, lactate dehydrogenase （LDH）, Mb and cTnl one day after the radical mastectomy were compared among the groups. Results In the post-operative levels of CK, CK-MB, AST, LDH and Mb among the groups, the levels in group T1 of tumor diameter（臆2.0 cm） were significantly lower than those in group T2 （2.1-5.0 cm） and group T3 （〉5.0 cm） （P 〈 0.05）, while those in group T2 were significantly lower than those in group T3 （P 〈 0.05）; the levels in level- I group of histological grade were significantly lower than those in level-Ⅰ group and level-Ⅱ group （P 〈 0.05）, while those in level-Ⅲ group were significantly lower than those in level-Ⅲ group （P 〈 0.05）; the levels in the group without lymphatic metastasis were significantly lower than those in the group with lymphatic metastasis （P 〈 0.05）; the levels in the positive group of estrogen and progestogen receptors were significantly lower than those in the negative group of estrogen and progestogen receptors （P 〈 0.05）. Conclusion After the radical mastectomy, the incidence of cardiac events is to some extent associated with such clinicopathologic features of tumor as the tumor diameter, histological grade, lymphatic metastasis and receptors of estrogen and progestogen.