人源性多肽、可溶性E-钙黏蛋白在乳腺癌中的表达及对患者预后的预测价值

Expression of dermcidin and soluble E-cadherin in breast cancer and their predictive value for prognosis of patients

目的探讨人源性多肽(DCD)、可溶性E-钙黏蛋白(sE-cadherin)在乳腺癌中的表达及对患者预后的预测价值。方法取298例乳腺癌患者的乳腺癌组织和相应癌旁组织,免疫组化法检测DCD、sE-cadherin的表达情况。随访半年,评估不同预后情况乳腺癌患者乳腺癌组织中DCD、sE-cadherin的表达情况,乳腺癌患者预后的影响因素采用多因素Logistic回归分析。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估DCD、sE-cadherin单独及联合检测对乳腺癌患者预后的预测价值。结果乳腺癌组织中DCD的阳性表达率明显高于癌旁组织,sE-cadherin的阳性表达率明显低于癌旁组织(P﹤0.01)。随访半年,298例乳腺癌患者,预后良好209例,预后不良89例。预后不良乳腺癌患者乳腺癌组织中DCD的阳性表达率明显高于预后良好患者,sE-cadherin的阳性表达率明显低于预后良好患者(P﹤0.05)。多因素Logistic回归分析结果显示,淋巴结转移、肿瘤直径≥5 cm、TNM分期为Ⅱ~Ⅲ期、DCD阳性表达、sE-cadherin阴性表达均为乳腺癌患者预后不良的独立危险因素(P﹤0.05)。DCD、sE-cadherin、DCD+sE-cadherin预测乳腺癌患者预后的AUC分别为0.795、0.711、0.887,DCD+sE-cadherin联合预测的AUC最大,此时的灵敏度、特异度分别为0.576、0.619。结论乳腺癌组织中DCD的阳性表达率较高,sE-cadherin的阳性表达率较低,二者联合检测对乳腺癌患者预后的预测价值较高。

Objective To investigate the expression of dermcidin(DCD)and soluble E-cadherin(sE-cadherin)in breast cancer and their predictive value for the prognosis of patients.Method The breast cancer tissues and corresponding adjacent tissues of 298 breast cancer patients were collected,and the expression of DCD and sE-cadherin were detected by immunohistochemistry.Follow-up for half a year to evaluate the expression of DCD and sE-cadherin in breast cancer tissue of breast cancer patients with different prognosis.Influencing factors of prognosis of breast cancer patients using Logistic regression analysis.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive value of DCD and sE-cadherin alone and in combination on the prognosis of breast cancer patients.Result The positive expression rate of DCD in breast cancer tissues was significantly higher than that in adjacent tissues,and the positive expression rate of sE-cadherin was significantly lower than that in adjacent tissues(P<0.01).During half a year of follow-up,209 patients with good prognosis and 89 patients with poor prognosis of 298 breast cancer patients were followed up.The positive expression rate of DCD in breast cancer tissue of patients with poor prognosis was significantly higher than that of patients with good prognosis,and the positive expression rate of sE-cadherin was significantly lower than that of patients with good prognosis(P<0.01).The results of multivariate Logistic regression analysis showed that lymph node metastasis,tumor diameter≥5 cm,TNM stage Ⅱ-Ⅲ,DCD positive expression,and sE-cadherin negative expression were independent risk factors for poor prognosis in breast cancer patients(P<0.05).The AUC of DCD,sE-cadherin,and DCD+sE-cadherin for predicting the prognosis of breast cancer patients were 0.795,0.711,and 0.887,respectively,and the AUC of DCD+sE-cadherin combined prediction was the largest,and the sensitivity and specificity were 0.576 and 0.619,respectively.Conclusion The positive expression rate of DCD in breast cancer tissues is high,and the positive expression rate of sE-cadherin is low,and the combined detection of the two has a high predictive value for the prognosis evaluation of breast cancer patients.