乳腺癌患者放化疗前后维生素D水平的变化

Clinical Significance of Serum Vitamin D Levels Change in Patients with Breast Cancer before and after Chemoradiotherapy

目的研究乳腺癌患者放化疗前后维生素D水平变化的临床意义.方法选取2016年6月至2017年6月西安交通大学第一附属医院肿瘤内科收治的乳腺癌患者(病例组)和健康女性(对照组)各100例,所有患者术后均接受辅助化疗和放疗,使用DRG ELISA试剂盒测量血清25-羟基维生素D3(25-OHD)水平.结果病例组与对照组在年龄、BMI、分娩次数、血红蛋白水平、总淋巴细胞和血小板计数方面差异无统计学意义(P>0.05).病例组维生素D缺乏率为100%,而对照组中维生素D缺乏率为85%.病例组放化疗前血清维生素D水平为(16.63±1.83)ng/m L,对照组为(25.56±6.64)ng/m L,病例组放化疗前维生素D水平显著低于对照组(P<0.001).病例组化放疗后维生素D平均水平为(11.35±2.87)ng/m L,显著低于放化疗前(P<0.001).采用2种不同的化疗方案,分别为FEC/T和CMF方案.放化疗前,2组患者之间维生素D水平差异无统计学意义(P>0.05).放化疗后,2组患者维生素D水平均显著降低(P<0.001),但2组患者之间维生素D水平差异无统计学意义(P>0.05).多重回归分析结果显示,年龄、BMI、分娩次数与放化疗前后维生素D水平变化显著相关(P<0.05),相关性自大至小依次为年龄、BMI、分娩次数.结论维生素D缺乏症可能与乳腺癌发病有关.患者年龄、BMI、分娩次数均与放化疗前后维生素D水平变化显著相关.

Objective To investigate the clinical significance of serum vitamin D levels change in patients with breast cancer（BC）before and after radiotherapy and chemotherapy.Methods A total of 100 BC patients and 100 healthy controls were enrolled in the First Affiliated Hospital of Xi＇an Jiaotong University from June 2016 to June 2017. All the patients received adjuvant chemotherapy and radiotherapy after operation. Serum 25-hydroxyvitamin D3（25-OHD） levels were measured using the DRG ELISA kit.Results There was no significant difference in age, BMI, times of deliveries, hemoglobin level, total lymphocyte count and platelet count between the cases and the controls（P〈0.05）. The incidence of vitamin deficiency was 100% in the case group and 85% in the control group. The level of serum vitamin D was（16.63 ± 1.83） ng/ml in the case group before radiotherapy and chemotherapy, and（25.56 ± 6.64） ng/m L in the control group. The level of vitamin D before radiotherapy and chemotherapy in the case group was significantly lower than that of the control group（P 〈0.001）. The mean level of vitamin D was（11.35 ± 2.87） ng/m L after radiotherapy and was significantly lower than that before radiotherapy and chemotherapy（P〈0.001）. Two different chemotherapy regimens were used in this study, FEC/T and CMF regimens. Before radiotherapy and chemotherapy, there was no significant difference in vitamin D levels between the two groups（P〈0.05）. After radiotherapy and chemotherapy, vitamin D levels in both groups were significantly decreased（P〈0.001）, but there was no significant difference between the two groups in vitamin D levels（P〈0.05）. Multiple regression analysis showed that age, BMI and number of deliveries were significantly correlated with changes of vitamin D levels before and after radiotherapy and chemotherapy（P〈0.05）, and correlations were as follows： age, BMI and times of deliveries.Conclusion Vitamin D deficiency may be associated with breast cancer. Patients＇ age, BMI and times of deliveries were significantly correlated with vitamin D levels before and after radiotherapy and chemotherapy.