E-钙黏蛋白、N-钙黏蛋白对乳腺癌术后腋窝淋巴结转移的诊断价值

The value of E-cadherin and N-cadherin in the diagnosis of axillary lymph node metastasis after breast cancer operation

目的探讨E-钙黏蛋白、N-钙黏蛋白对乳腺癌保乳手术术后腋窝淋巴结转移的诊断价值。方法选取2015年1月—2017年1月于本院行保乳术治疗且术后3年内(随访截止至2020年1月)腋窝淋巴结转移的78例乳腺癌患者为研究对象(转移组,n=78),另选未发生腋窝淋巴结转移的50例乳腺癌患者作为对照(无转移组,n=50),分别采用免疫组化法、实时定量聚合酶链反应(RT-PCR)法对2组患者肿瘤组织中E-钙黏蛋白、N-钙黏蛋白进行定性、定量测定。采用受试者工作特征(ROC)曲线评价E-钙黏蛋白、N-钙黏蛋白表达水平对乳腺癌保乳术后腋窝淋巴结转移的诊断效能。结果免疫组化结果显示,转移组E-钙黏蛋白阳性表达率低于无转移组(P<0.05)、N-钙黏蛋白阳性表达率高于阴性患者(P<0.05)。RT-PCR结果显示,转移组E-钙黏蛋白mRNA相对表达值低于无转移组(P<0.05)、N-钙黏蛋白mRNA相对表达值高于阴性患者,上述差异均有统计学意义(P<0.05)。ROC曲线分析发现,E-钙黏蛋白mRNA相对值取0.47时,灵敏度、特异度分别为89.74%、72.00%;N-钙黏蛋白mRNA相对值取0.45时,灵敏度、特异度分别为80.77%、80.00%。结论E-钙黏蛋白表达水平降低、N-钙黏蛋白表达水平升高与乳腺癌患者保乳术后腋窝淋巴结转移相关,可通过测定二者表达水平对乳腺癌患者保乳术后腋窝淋巴结转移进行辅助诊断。

Objective To investigate the value of E-cadherin and N-cadherin in the diagnosis of axillary lymph node metastasis after breast cancer operation.Methods Seventy-eight breast cancer patients with axillary lymph node metastasis who underwent breast conserving surgery in our hospital and had been followed up for 3 years(up to January 2020)were selected as the study objects(metastasis group,n=78)from January 2015 to January 2017.Fifty breast cancer patients without axillary lymph node metastasis were selected as the control(no-metastasis group,n=50).Immunohistochemistry and real-time quantitative PCR were used respectively RT-PCR was used to determine the E-cadherin and N-cadherin in the tumor tissues of the two groups.ROC curve was used to evaluate the diagnostic effect of E-cadherin and N-cadherin on axillary lymph node metastasis after breast conserving surgery.Results The results of immunohistochemistry showed that the positive rate of E-cadherin in the metastasis group was lower than that in the no-metastasis group(P<0.05),and the positive rate of N-cadherin was higher than that in the No metastasis group(P<0.05).RT-PCR showed that the relative expression of E-cadherin mRNA in the metastasis group was lower than that in the no-metastasis group(P<0.05),and the relative expression of N-cadherin mRNA in the metastasis group was higher than that in the no-metastasis group,with the above differences statistically significant(P<0.05).ROC curve analysis showed that when the relative value of E-cadherin mRNA was 0.47,sensitivity and specificity were 89.74%and 72.00%,respectively;when the relative value of N-cadherin mRNA was 0.45,sensitivity and specificity were 80.77%and 80.00%,respectively.Conclusion The decreased expression of E-cadherin and the increased expression of N-cadherin are related to the axillary lymph node metastasis in breast cancer patients after breast conserving surgery.The detection of the levels of E-cadherin and N-cadherin can be used to assist the diagnosis of axillary lymph node metastasis in breast cancer patients after breast conserving surgery.