血清碱性磷酸酶、乳酸脱氢酶对乳腺癌患者生存预后的评估价值

Evaluation of Serum Alkaline Phosphatase and Lactate Dehydrogenase in the Prognosis of Patients with Breast Cancer

目的 探讨血清碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)对乳腺癌患者生存预后的评估价值。方法 回顾性分析Ⅱ~Ⅲ期乳腺癌患者64例作为研究对象,所有患者均行外科根治术与术后常规辅助放化疗,治疗后随访3年,根据随访期间是否发生肿瘤复发分为肿瘤复发转移组(n=34)与非复发转移组(n=30),分析两组患者治疗前后血清ALP、LDH水平变化,及其与患者预后的关系。结果 复发转移组治疗前后ALP水平高于非复发转移组(P<0.05);两组患者治疗前血清LDH水平比较差异无统计学意义(P>0.05),治疗后复发转移组患者血清LDH水平明显高于非复发转移组的(P<0.05);Spearman相关性分析显示,治疗后血清碱性磷酸酶、乳酸脱氢酶水平与中期乳腺癌患者治疗后肿瘤复发转移发生风险呈正相关关系(γ=0.588,γ=0.439,P<0.05);ROC曲线分析显示:联合治疗后血清ALP+LDH水平预测中期乳腺癌患者治疗后3年内发生肿瘤复发转移明显高于血清ALP、LDH单项预测的。结论 乳腺癌患者治疗后血清碱性磷酸酶、乳酸脱氢酶水平与治疗后肿瘤复发转移具有一定相关性,可作为生存预后评估辅助指标之一。

Objective To evaluate the prognostic value of serum alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in patients with advanced breast cancer. Methods 64 patients diagnosed with stage Ⅱ~Ⅲ breast cancer were selected as the study subjects.All the patients underwent radical surgery and conventional adjuvant chemoradiotherapy after follow-up for 3 years,according to whether tumor recurrence during follow-up was divided into tumor recurrence and metastasis and non-recurrence metastasis,the changes of serum ALP and LDH levels before and after treatment in both groups were analyzed,The relationship between tumor recurrence and metastasis after treatment. Results The ALP level in the recurrence and metastasis group was higher than that of the non-recurrence group.There was no significant difference in serum LDH levels between the 2 groups before treatment.Serum LDH levels in the patients with recurrent or metastatic disease were significantly higher than those of the non -recurrent metastatic group.Spearman correlation analysis showed that serum ALP and LDH levels were positively correlated with the recurrence and metastasis of breast cancer patients after treatment (γ=0.588,γ=0.439, P <0.05).ROC curve analysis showed that serum ALP+LDH level after combination therapy predicted the tumor recurrence and metastasis within 3 years after treatment in patients with advanced breast cancer was significantly higher than the single predictions of serum ALP and LDH. Conclusion Serum alkaline phosphatase and lactate dehydrogenase levels in patients with advanced breast cancer after treatment are correlated with tumor recurrence and metastasis after treatment,which can be used as an adjunct to survival prognosis evaluation.