外周血生化指标对乳腺癌患者淋巴结转移的预测价值

Evaluation of biochemical indexes of peripheral blood in predicting lymph node metastasis of breast cancer patients

目的分析外周血生化指标对乳腺癌患者淋巴结转移的预测价值。方法回顾性收集300例体检健康者(对照组)以及306例乳腺癌患者(乳腺癌组)的临床和生化指标资料,同时,根据乳腺癌患者是否发生淋巴结转移,分为转移组和未转移组。比较对照组和乳腺癌组,以及转移组和未转移组之间生化指标的差异,并进一步利用Logistic回归筛选淋巴结转移的独立危险因素。结果乳腺癌组患者外周血中碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、尿素氮(BUN)、尿酸(UA)、三酰甘油(TG)、α-羟丁酸脱氢酶(α-HBDH)、脂蛋白(a)[LP(a)]、总胆汁酸(TBA)水平显著高于对照组(P<0.05);总蛋白(TP)、清蛋白(ALB)、球蛋白(GLO)、丙氨酸氨基转移酶(ALT)、ALT/天门冬氨酸氨基转移酶(AST)、胆碱酯酶(CHE)、直接胆红素(DBIL)、肌酐(CREA)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平显著低于对照组(P<0.05)。转移组患者外周血中ALT/AST水平显著低于未转移组患者,差异有统计学意义(P<0.05);CK-MB、CK-MB/CK水平高于未转移组患者,差异均有统计学意义(P<0.05)。Logistic回归分析显示,CK-MB/CK(P=0.006,OR=24.744)以及TBIL(P=0.019,OR=1.065)是乳腺癌淋巴结转移的独立危险因素。结论CK-MB/CK和TBIL是乳腺癌淋巴结转移的独立危险因素,对预测淋巴结转移可能具有一定价值。

Objective To investigate the value of biochemical indexes of peripheral blood in predicting lymph node metastasis of breast cancer patients.Methods The clinical and biochemical indexes data from 300 healthy subjects(control group)and 306 breast cancer patients(breast cancer group)were retrospectively analyzed.And according to the patients had lymph node metastasis or not,they were divided into metastasis group and non-metastasis group.Biochemical indexes between control group and breast cancer group,metastasis group and non-metastasis group of breast cancer patients were compared,furthermore,Logistic regression analysis was performed to screen the independent influencing factors of lymph node metastasis.Results In the breast cancer group,the levels of alkaline phosphatase(ALP),lactate dehydrogenase(LDH),creatine kinase(CK),CK-MB,urea nitrogen(BUN),uric acid(UA),triacylglycerol(TG),α-hydroxybutyrate dehydrogenase(α-HBDH),lipoprotein(a)[LP(a)],total bile acids(TBA)were significantly higher than that of control group(P<0.05).And levels of total protein(TP),albumin(ALB),globulin(GLO),alanine aminotransferase(ALT),ALT/aspartate aminotransferase(AST),cholinesterase(CHE),direct bilirubin(DBIL),creatinine(CREA),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)were significant lower than that of control group(P<0.05).ALT/AST of metastasis group was significantly lower than that of non-metastasis group(P<0.05).CK-MB and CK-MB/CK of metastasis group were higher than that of non-metastasis group(P<0.05).Logistic regression analysis revealed that CK-MB/CK(P=0.006,OR=24.744)and TBIL(P=0.019,OR=1.065)were independent risk factors for lymph node metastasis of breast cancer.Conclusion CK-MB/CK and TBIL are the independent risk factors for lymph node metastasis of breast cancer,which might have a certain value in predicting lymph node metastasis.