miR⁃34、VEGF⁃C及sIL⁃2R检测在乳腺癌淋巴结转移中的预测

Prediction of detection of mir⁃34、VEGF⁃C and sIL⁃2R in lymph node metastasis of breast cancer

目的探讨血清微小RNA(miR34)、血管内皮生长因子(VEGF⁃C)及可溶性白细胞介素⁃2受体(sIL⁃2R)水平与乳腺癌淋巴结转移的关系。方法选取2015年3月至2019年3月在本院就诊的97例乳腺癌患者,根据是否有淋巴结转移分为淋巴结转移组40例、无淋巴结转移组57例,选取同期在本院进行体检的97例健康者作为对照组。比较各组miR⁃34、VEGF⁃C、sIL⁃2R水平,绘制ROC曲线,分析三者单一检测及联合预测乳腺癌淋巴结转移的AUC、灵敏度、特异度。结果三组之间miR⁃34水平比较:对照组>无淋巴结转移组>淋巴结转移组,差异有统计学意义(P<0.05)。三组之间VEGF⁃C、sIL⁃2R水平比较:淋巴结转移组>无淋巴结转移组>对照组,差异有统计学意义(P<0.05)。病理学分级为低、中分化的患者miR⁃34低于高分化的患者,VEGF⁃C、sIL⁃2R高于高分化的患者,差异均有统计学意义(P<0.05)。TNM分期为Ⅰ~Ⅱ期的患者miR⁃34高于Ⅲ~Ⅵ期的患者,VEGF⁃C、sIL⁃2R低于Ⅲ~Ⅵ期的患者,差异均有统计学意义(P<0.05)。有淋巴血管间隙浸润的患者miR⁃34低于无淋巴血管间隙浸润的患者,VEGF⁃C、sIL⁃2R高于无淋巴血管间隙浸润的患者,差异均有统计学意义(P<0.05)。miR⁃34、VEGF⁃C、sIL⁃2R及三者联合检测灵敏度、特异度分别为93.65%、94.23%,显著高于单一检测(P<0.05)。结论miR⁃34、VEGF⁃C、sIL⁃2R与乳腺癌淋巴结转移情况有关,联合三者检测对评估乳腺癌病情、预测淋巴结转移情况作用重大。

Objective To explore the relationship between the levels of serum microRNA(mi⁃croRNA,miR34),vascular endothelial growth factor C(VEGF⁃C)and soluble interleukin⁃2 receptor(sIL⁃2R)and lymph node metastasis of breast cancer.Methods The 97 patients with breast cancer who were treat⁃ed in this hospital from March 2015 to March 2019 were selected.According to the presence or absence of lymph node metastasis,they were divided into 40 cases in the lymph node metastasis group and 57 cases in the non⁃lymph node metastasis group.97 healthy patients who underwent physical examination in this hospital during the same period were selected as the control group.The levels of miR⁃34,VEGF⁃C,and sIL⁃2R in dif⁃ferent groups were compared,the ROC curves were drawn,and the AUC,sensitivity,and specificity of the three single detection and combined detection in predicting lymph node metastasis of breast cancer were ana⁃lyzed.Results The levels of miR⁃34 among the three groups were as follows:the control group>the non⁃lymphatic metastasis group>the lymph node metastasis group,the difference was statistically significant(P<0.05).The levels of VEGF⁃C and sIL⁃2R among the three groups were as follows:the lymph node metastasis group>the non⁃lymph node metastasis group>the control group,the difference was statistically significant(P<0.05).The pathological grade of patients with low and moderately differentiated miR⁃34 was lower than that of well⁃differentiated patients,and VEGF⁃C and sIL⁃2R were higher than those of well⁃differentiated pa⁃tients.The differences were statistically significant(P<0.05).The miR⁃34 of patients at stageⅠ~Ⅱin TNM stage was higher than that at stageⅢ~Ⅵ,and the VEGF⁃C and sIL⁃2R were lower than those of stageⅢ~Ⅵ.The differences were statistically significant(P<0.05).The miR⁃34 of patients with lymphatic vascular space infiltration was lower than that of patients without lymphatic vascular space infiltration,and VEGF⁃C and sIL⁃2R were higher than those without lymphatic vascular space infiltration.The differences were statistically signifi⁃cant(P<0.05).The sensitivity and specificity of the combined detection of miR⁃34,VEGF⁃C,and sIL⁃2R were 93.65%and 94.23%,respectively,which were significantly higher than those of the single miR⁃34,VEGF⁃C,and sIL⁃2R detection.Conclusion miR⁃34,VEGF⁃C,and sIL⁃2R are related to the lymph node metastasis of breast cancer,and the combined detection of the three has a significant effect on the assessment of breast cancer and the prediction of lymph node metastasis.