血浆HA与外周血M2型单核细胞/M1型单核细胞比值联合检测在乳腺癌中的临床应用价值

Combined determination of plasma hyaluronan and the ratio of M2 monocyte/M1 monocyte ratio in breast cancer

目的探讨血浆透明质酸(HA)与外周血M2型单核细胞/M1型单核细胞比值(简称M2/M1比值)联合检测在乳腺癌中的临床应用价值。方法选取98例乳腺癌患者(乳腺癌组)、37例乳腺良性疾病患者(乳腺良性疾病组)和41名体检健康者(正常对照组)。采用化学发光法检测血浆HA和糖类抗原(CA)15-3水平;采用流式细胞术检测外周血M1型(CD14+CD163-CD86+)和M2型(CD14+CD163+CD204+)单核细胞的表达,并计算M2/M1比值。各项指标之间的相关性分析采用Spearman相关分析。采用受试者工作特征(ROC)曲线分析各项指标的诊断效能。结果乳腺癌组血浆HA、CA15-3水平及M2型单核细胞比例、M2/M1比值均明显高于乳腺良性疾病组及正常对照组(P<0.05),而乳腺良性疾病组与正常对照组之间差异均无统计学意义(P>0.05)。HA与M2/M1比值、M2型单核细胞比例、M1型单核细胞比例均相关(rs值分别为0.401、0.393、-0.189,P<0.05)。M2/M1比值诊断乳腺癌的曲线下面积(AUC)、敏感性和特异性均高于其他指标,且HA与M2/M1比值联合检测可提高对乳腺癌的诊断效能。血浆HA与乳腺癌组织学分化情况有关(P<0.05),M2/M1比值与乳腺癌TNM分期、淋巴结转移、组织学分化情况及雌激素受体(ER)均有关(P<0.05),CA15-3与乳腺癌临床病理特征均无关(P>0.05)。结论 HA与M2/M1比值联合检测对辅助诊断乳腺癌具有一定的临床价值。

Objective To investigate the role of the combined determination of plasma hyaluronan(HA)and the ratio of M2 monocyte/M1 monocyte(M2/M1 ratio)in breast cancer.Methods A total of 98 patients with breast cancer(breast cancer group),37 patients with breast benign diseases(breast benign disease group)and 41 healthy subjects(healthy control group)were enrolled.Plasma HA and carbohydrate antigen(CA)15-3 levels were determined by chemiluminescence.Flow cytometry was used to assess the expression of M1(CD14^+CD163^-CD86^+)and M2(CD14^+CD163^+CD204^+)monocytes,and M2/M1 ratio was calculated.Correlation analysis was performed using Spearman correlation analysis.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of each marker.Results Plasma HA and CA15-3 levels,the proportion of M2 monocyte and M2/M1 ratio were higher in breast cancer group than those in breast benign disease and healthy control groups(P<0.05),and there was no statistical significance between breast benign disease and healthy control groups(P >0.05).There were correlations of HA with M2/M1 ratio and the proportions of M2 monocyte and M1 monocyte(rs=0.401,0.393 and-0.189,P<0.05).The area under ROC curve(AUC),sensitivity and specificity of M2/M1 ratio for the diagnosis of breast cancer were higher than those of the other markers,and the combined determination of HA and M2/M1 ratio could improve the diagnostic efficiency of breast cancer.Plasma HA was correlated with the histological differentiation of breast cancer(P<0.05),and M2/M1 ratio was correlated with tumor-node-metastasis(TNM)stage,histological differentiation,lymph node metastasis and estrogen receptor(ER)(P<0.05).However,there was no relationship between CA15-3 and clinicopathological characteristics(P >0.05).Conclusions The combined determination of HA and M2/M1 ratio plays a role in the auxiliary diagnosis of breast cancer.