接受不同化疗方案乳腺癌患者血清B族维生素水平检测及其临床意义

Detection of serum vitamin-B levels in breast cancer patients receiving different chemotherapy regimens and its clinical significance

目的:检测接受不同化疗方案乳腺癌患者血清B族维生素水平,阐明接受不同化疗方案乳腺癌患者血清B族维生素水平差异及其临床意义。方法:回顾性分析乳腺癌化疗患者(病例组,n=62)和健康体检者(对照组,n=48)的临床资料。根据乳腺癌患者血清维生素B12(VitB12)、维生素B9(VitB9)和维生素B6(VitB6)水平,将其分为6个亚组,分别为VitB12<0.025μg·L^(-1)组与VitB12≥0.025μg·L^(-1)组、VitB9<3.93μg·L^(-1)组与VitB9≥3.93μg·L^(-1)组、VitB6<1.955μg·L^(-1)组与VitB6≥1.955μg·L^(-1)组,统计不同亚组乳腺癌患者的基线特征和化疗方案。病例组患者根据化疗方案分为AC-T组21例、EC-T组22例、TC组11例和其他化疗方案组8例。于第1个化疗周期时在输注完全部化疗药物后的第2天清晨,取患者空腹血清,采用液相色谱-串联质谱仪检测2组研究对象血清B族维生素水平,并比较和分析接受不同化疗方案的乳腺癌患者血清B族维生素水平及不同血清B族维生素水平乳腺癌患者的化疗方案。结果:对照组研究对象血清VitB9水平高于病例组(t=-3.343,P<0.05)。病例组患者血清VitB12和VitB6水平与对照组比较差异无统计学意义(P>0.05)。血清VitB12<0.025μg·L^(-1)组和VitB12≥0.025μg·L^(-1)组乳腺癌患者间是否绝经比较差异有统计学意义(χ^(2)=7.127,P=0.008),年龄、体质量指数(BMI)、TNM分期、肿瘤大小、有无淋巴结转移、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(Her-2)、Ki-67和病理分型比较差异均无统计学意义(P>0.05);VitB6<1.955μg·L^(-1)组和VitB6≥1.955μg·L^(-1)组乳腺癌患者间淋巴结有无转移比较差异有统计学意义(χ^(2)=6.057,P=0.014),年龄、BMI、是否绝经、TNM分期、肿瘤大小、ER、PR、Her-2、Ki-67和病理分型比较差异无统计学意义(P>0.05)。VitB9<3.93μg·L^(-1)组和VitB9≥3.93μg·L^(-1)组乳腺癌患者间年龄、是否绝经、BMI、TNM分期、肿瘤大小、有无淋巴结转移、ER、PR、Her-2、Ki-67和病理分型比较差异无统计学意义(P>0.05)。在纳入的62例乳腺癌患者中,有11例行TC方案治疗,21例行AC-T方案治疗,22例行EC-T方案治疗,8例行其他化疗方案,接受不同化疗方案的乳腺癌患者血清VitB12、VitB9和VitB6水平比较差异无统计学意义(P>0.05)。结论:采用不同化疗方案的乳腺癌患者血清B族维生素水平无明显差异,但乳腺癌化疗患者血清VitB9水平与正常人比较有明显差异。

Objective:To detect the serum B vitamin levels in the breast cancer patients who were receiving different chemotherapy regimens,and to clarify the differences in serum B vitamin levels in the breast cancer patients with different chemotherapy regimens and their clinical significances.Methods:The clinical data of breast cancer chemotherapy patients(case group,n=62)and healthy subjects(control group,n=48)were retrospectively analyzed.According to the serum levels of vitamin B12(VitB12),vitamin B9(VitB9)and vitamin B6(VitB6),the breast cancer patients were divided into six subgroups:VitB12<0.025μg·L^(-1)group and VitB12≥0.025μg·L^(-1)group,VitB9<3.93μg·L^(-1)group and VitB9≥3.93μg·L^(-1)group,VitB6<1.955μg·L^(-1)group and VitB6≥1.955μg·L^(-1)group.The baseline characteristics and chemotherapy regimens of breast cancer patients in different subgroups were analyzed.The patients in case group were divided into AC-T group(n=21),EC-T group(n=22),TC group(n=11),and the other chemotherapy regimen group(n=8)according to the chemotherapy regimen.In the first chemotherapy cycle,in the early morning of the second day after infusion of all chemotherapeutics,the fasting serum was collected from the patients,and the serum B vitamin levels of the subjects in two groups were detected by liquid chromatography-tandem mass spectrometry.The levels of serum vitamin B in breast cancer patients with different chemotherapy regimens and the chemotherapy regimens of breast cancer patients with different serum B vitamins levels were compared and analyzed.Results:The level of serum VitB9 in the subjets in control group was significantly higher than that in case group(t=-3.343,P<0.05).The serum levels of VitB12 and VitB6 in the patients in case group had no significant differences compared with control group(P>0.05).There was a statistically significant difference in menopause or not between VitB12<0.025μg·L^(-1)group and VitB12≥0.025μg·L^(-1)group(t=7.127,P=0.008).There were no statistically significant differences in age,body mass index(BMI),TNM stage,tumor size,lymph node metastasis,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(Her-2),Ki-67,and pathological classification between VitB12<0.025μg·L^(-1)group and VitB12≥0.025μg·L^(-1)group(P>0.05);there was a statistically significant difference in lymphnode metastasis between VitB6<1.955μg·L^(-1)group and VitB6≥1.955μg·L^(-1)group(t=6.057,P=0.014);there were no statistically significant differences in age,BMI,menopause or not,TNM stage,tumor size,ER,PR,Her-2,Ki-67,and pathological types between VitB6<1.955μg·L^(-1)group and VitB6≥1.955μg·L^(-1)group(P>0.05).There were no significant differences in age,menopause or not,BMI,TNM stage,tumor size,lymphnode metastasis,ER,PR,Her-2,Ki-67,and pathological classification between VitB9<3.93μg·L^(-1)group and VitB9≥3.93μg·L^(-1)group(P>0.05).Among the 62 breast cancer patients included,11 cases were treated with TC chemotherapy regimen,21 cases were treated with AC-T chemotherapy regimen,22 cases were treated with EC-T chemotherapy regimen,and 8 cases were treated with other chemotherapy regimens;there were no significant differences in the serum levels of VitB12,VitB9 and VitB6 among the breast cancer patients received different chemotherapy regimens(P>0.05).Conclusion:There are no significant differences in the serum vitamin B levels in the breast cancer patients received different chemotherapy regimens,but there is a significant difference in the serum VitB9level in the breast cancer chemotherapy patients compared with normal controls.