多效生长因子在乳腺癌中的表达及诊断价值

Clinical significance of the pleiotrophin expression in breast cancer

目的探讨多效生长因子(pleiotrophin,PTN)在乳腺癌中的表达及诊断价值。方法采集乳腺癌患者及健康体检者组织及血液样本,检测血液样本中PTNmRNA和蛋白的表达差异。电化学发光法测定血浆中糖类蛋白153(carbohydrate antigen153,CA153)、癌胚抗原(carcinoembryonic antigen,CEA)、糖类蛋白125(carbohydrate antigen125,CA125)表达水平,绘制ROC曲线分析PTN与CA153、CEA、CA125等联合检测对乳腺癌的诊断价值。结果乳腺癌患者组血清PTN表达水平高于乳腺良性病变组和健康对照组(P<0.05),乳腺良性病变组和健康对照组差异无统计学意义(t=-1.56,P>0.05);PTNmRNA及蛋白的表达水平乳腺癌组织显著高于癌旁正常组织(P<0.05),且PTN的表达水平与患者远处转移、TNM分期、分化程度密切相关。PTN诊断乳腺癌的AUC为0.893(P<0.05)高于血清CA153、CEA、CA125,联合检测时,ROC曲线下面积为最大。结论检测血清PTN水平有助于评估乳腺癌的转移风险和预后情况,PTN联合CA153、CEA以及CA125检测时可明显提高对乳腺癌的诊断价值。

Objective To investigate the expression level and its clinical significance of pleiotrophin(PTN)in breast cancer.Methods Blood samples were collected from both breast cancer patients and healthy controls.The expression level of PTN in serum was measured by ELISA.RT-PCR and Western blot was used to detect the expression of PTN mRNA and protein in cancer tissues and adjacent tissues.The expression of CA153,CEA and CA125 in plasma of breast cancer and healthy person were determined by electrochemical luminescence.The receiver operating characteristic curve(ROC curve)was drawn for evaluated diagnostic efficacy of PTN,CA153,CEA and CA125 for breast cancer.Results The serum PTN expression level in breast cancer patients was higher than that in benign breast lesions and healthy control group(P<0.05).PTN mRNA and protein expression in the cancer tissue was significantly higher than that in adjacent normal tissues(P<0.05).The expression of PTN have high correlation with distant metastasis,stageⅢ+Ⅳ,and poorly differentiated(P<0.01).The AUC of PTN for the diagnosis of breast cancer was 0.913(P<0.05).The area under the ROC curve is the largest when the four tests are combined.Conclusions Detection of serum PTN levels are helpful in assessing the risk of metastasis and prognosis of breast cancer.Combined detection of serum PTN,CA153,CEA and CA125 can significantly improve the diagnostic value of breast cancer.