乳腺癌患者手术前后CA-153、SCC和HE4水平变化及复发预测分析

Changes of CA-153,SCC and HE4 levels and prediction of recurrence in breast cancer patients before and after surgery

目的分析乳腺癌患者手术前后糖类抗原-153(CA-153)、鳞状细胞癌抗原(SCC)及人附睾蛋白4(HE4)水平变化及在复发预测中的应用价值。方法2019年1月至2020年12月于承德市第三医院行外科手术治疗的乳腺癌患者102例(观察组),另选取本院同期体检健康人群98名作为对照组。对观察组进行为期12个月随访,统计患者复发情况,检测不同人群CA-153、SCC及HE4水平,分析CA-153、SCC及HE4对乳腺癌术后复发的预测价值。结果CA-153、SCC、HE4表达水平为:观察组治疗前>观察治疗后>对照组,差异均有统计学意义(P<0.05)。随访截止至2021年12月31日,所有患者均未失访,102例乳腺癌患者中复发者21例,未复发者81例。术后复发者病理分期为Ⅲ~ⅣV期、肿瘤直径≥5 cm、术后未辅助治疗、术后CA-153≥30 U/L、SCC≥1.5 ng/mL、HE4≥70 pmol/L占比明显高于术后未复发者,差异均有统计学意义(P<0.05)。经多元Logistic回归分析可知,术前病理分期、肿瘤直径以及术后是否辅助治疗、术后CA-153、SCC及HE4水平为影响乳腺癌患者复发的相关危险因素(P<0.05)。结论CA-153、SCC及HE4表达水平与乳腺癌患者术后复发密切相关,监测CA-153、SCC、HE4表达水平可为患者术后复发预测提供参考依据。

Objective To analyze the changes of carbohydrate antigen-153(CA-153),squamous cell carcinoma antigen(SCC)and human epididymal protein 4(HE4)levels in breast cancer patients before and after surgery and its application value in recurrence prediction.Methods 102 breast cancer patients who underwent surgical treatment in Chengde Third Hospital from January 2019 to December 2020 were selected(observation group),another 98 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.The observation group were followed up for 12 months,the recurrence of the patients was counted,and the levels of CA-153,SCC and HE4 in different populations were detected,and the predictive effects of CA-153,SCC and HE4 for postoperative recurrence of breast cancer were analyzed.Results The expression levels of CA-153,SCC and HE4 were as follows:before treatment in the observation group>after treatment in the observation group>the control group,and the differences were statistically significant(P<0.05).The follow-up ended on December 31,2021;all patients were not lost to follow-up.Among the 102 breast cancer patients,21 had recurrence and 81 had no recurrence.The pathological stageⅢ~Ⅳ,tumor diameter≥5 cm,no postoperative adjuvant therapy,the proportions of postoperative CA-153≥30 U/L,SCC≥1.5 ng/m L,HE4≥70 pmol/L in patients with postoperative recurrence were significantly higher than those without postoperative recurrence,and the differences were statistically significant(P<0.05),but there was no difference in age and pathological type(P<0.05).Multiple logistic regression analysis showed that preoperative pathological stage,tumor diameter and postoperative whether adjuvant therapy,postoperative CA-153,SCC and HE4 levels were the relevant risk factors for breast cancer recurrence(P<0.05).Conclusion The expression levels of CA-153,SCC and HE4 are closely related to postoperative recurrence of breast cancer patients.Monitoring the expression levels of CA-153,SCC and HE4 can provide reference for the prediction of postoperative recurrence of patients.