乳腺癌肿瘤标记物乳腺癌分子亚型与乳腺X线密度关系研究

Relationship between breast cancer tumor markers and molecular subtypes and mammographic density

目的探讨乳腺癌肿瘤标记物、乳腺癌分子亚型与乳腺X线密度间的关系。方法采用病例对照研究回顾性分析2019年7月至2020年10月间就诊于山西省人民医院乳腺科并经数字乳腺X线确诊为乳腺癌456例、对照组912例,使用Quantra软件评估所有女性乳腺X线密度[乳腺纤维腺体体积(VFG)、乳腺体积及纤维腺体体积百分比(VBD)],采用条件配对Logistic回归模型分析乳腺癌肿瘤标志物及分子亚型与乳腺X线密度(VFG、VBD)的关系。结果与VFG Q1类相比,Q4类女性患雌激素受体阳性乳腺癌的风险增加0.57倍(P=0.006)、患雌激素受体阴性乳腺癌的风险增加1.09倍(P=0.02)、患孕激素受体阳性乳腺癌的风险增加0.52倍(P=0.005)、患孕激素受体阴性乳腺癌的风险增加1.15倍(P=0.01);患人类表皮生长因子(HER)2阴性乳腺癌的风险增加0.60倍(P=0.03)。与VFG Q1类相比,Q4类女性患Luminal A型及Luminal B型乳腺癌的风险增加分别是0.95倍和0.53倍(P分别为0.03、0.01)。VBD分层中,以Q1类为参照,所有肿瘤标志物及分子亚型各分组间差异无统计学意义(P均>0.05)。结论乳腺X线密度影响乳腺癌的风险机制可能存在雌激素通路之外。

Objective To investigate the relationship between breast cancer tumor markers and molecular subtypes and mammographic density.Methods A total of 456 patients with breast cancer diagnosed by digital mammography in the Department of Breast Cancer,Shanxi Provincial People′s Hospital between July 2020 and October 2020 and 912 cases(control group)were included,and a case-control study was conducted for the retrospective analysis.The mammographic density including volume of fibroadenoma(VFG)and volumetric breast density(VBD)were assessed by Quantra software.The correlation between breast cancer tumor biomarkers and molecular subtypes and mammographic density(VFG and VBD)was analyzed by conditional paired Logistic regression model.Results Compared with VFG Q1,females with VFG Q4 had a 0.57-fold increased risk of developing ER+breast cancer(P=0.006),1.09-fold increased risk of developing ER-breast cancer(P=0.02),0.52-fold increased risk of developing PR+breast cancer(P=0.005),and 1.15-fold increased risk of developing PR-breast cancer(P=0.01),respectively.There was also a 0.60-fold increased risk of developing HER2-negative breast cancer(P=0.03).Compared with VFG Q1,females with VFG Q4 had a 0.95-fold and 0.53-fold increased risk of developing Luminal A and Luminal B breast cancers,respectively(P=0.03,0.01,respectively).In VBD stratification,with Q1 category as the reference,there were no statistically significant differences in all tumor markers and molecular subtypes among the groups(all P>0.05).Conclusion The risk mechanism of mammographic density affecting the incidence of breast cancer may be out of the estrogen pathway.