ABCG2基因多态性联合血清CA153、CEA预测乳腺癌术后复发的价值

The value of ABCG2 gene polymorphism combined with serum CA153 and CEA in predicting postoperative recurrence of breast cancer.

目的分析三磷酸腺苷结合盒家族G2(ABCG2)基因多态性联合糖类抗原153(CA153)、癌胚抗原(CEA)预测乳腺癌术后复发的价值。方法回顾性选取2020年3月至2022年3月阳泉市第一人民医院收治的接受手术治疗后2年内复发的乳腺癌患者96例为复发组,同期选取手术治疗后2年内未复发患者90例为未复发组。比较两组基线资料及血清CA153、CEA水平,分析两组ABCG2基因不同单核苷酸多态性位点基因型及等位基因频率分布情况。采用多因素Logistic回归分析乳腺癌术后复发的独立危险因素,绘制受试者工作特性曲线(ROC)评价ABCG2基因多态性联合血清CA153、CEA预测乳腺癌术后复发的效能。结果复发组肿瘤直径≥5 cm、TNM分期为Ⅲ期、组织学分级为Ⅲ级、淋巴结转移数目≥4个、雌激素受体(ER)/孕激素受体(PR)阴性占比明显高于未复发组,血清CA153、CEA水平明显高于未复发组,差异均有统计学意义(P<0.05)。复发组携带ABCG2基因rs2032582位点GG基因型占比明显高于未复发组,差异有统计学意义(P<0.05)。肿瘤直径≥5 cm、TNM分期>Ⅱ期、组织学分级>Ⅱ级、淋巴结转移数目≥4个、CA153≥36.600 U/mL、CEA≥1.855μg/L、携带ABCG2基因rs2032582位点GG基因型是乳腺癌术后复发的独立危险因素(P<0.05),ER/PR阳性是乳腺癌术后复发的独立保护因素(P<0.05)。ABCG2基因rs2032582位点GG基因型、CA153、CEA联合对乳腺癌术后复发有较高的预测效能,曲线下面积为0.968,预测敏感度为0.958,特异度为0.978。结论除肿瘤直径、TNM分期、组织学分级、淋巴结转移数目、ER/PR状态外,CA153、CEA和携带ABCG2基因rs2032582位点GG基因型也是乳腺癌术后复发的危险因素,且其联合预测乳腺癌术后复发的效能较高,值得临床验证。

Objective The value of adenosine triphosphate binding box family G2 gene polymorphism combined with carbohydrate antigen 153(CA153)and carcino-embryonic antigen(CEA)in predicting postoperative recurrence of breast cancer was analyzed.Methods A total of 96 breast cancer patients who had recurrence within 2 years after surgical treatment in Yangquan First People's Hospital from March 2020 to March 2022 were retrospectively selected as the recurrence group,and 90 patients who had no recurrence within 2 years after surgical treatment were selected as the non-recurrence group.The baseline data and serum CA153 and CEA levels were compared between the two groups,and the genotypes and allele frequency distribution of different single nucleotide polymorphism loci of ABCG2 gene in the two groups were analyzed.Multivariate Logistic regression was used to analyze the independent risk factors for postoperative recurrence of breast cancer,and receiver operating characteristic curve(ROC)was drawn to evaluate the efficacy of ABCG2 gene polymorphism combined with serum CA153 and CEA in predicting postoperative recurrence of breast cancer.Results The tumor size≥5 cm,TNM stageⅢ,histological gradeⅢ,number of lymph node metastasis≥4,estrogen receptor(ER)/progesterone receptor(PR)negative ratio in the recurrence group were significantly higher than those in the non-recurrence group,serum CA153 and CEA levels were significantly higher than those in the non-recurrence group,the differences were statistically significant(P<0.05).The proportion of GG genotype of RS2032582 of ABCG2 gene in recurrence group was significantly higher than that in non-recurrence group,the difference was statistically significant(P<0.05).Tumor size≥5 cm,TNM stage>Ⅱ,histological grade>Ⅱ,number of lymph node metastasis≥4,CA153≥36.600 U/mL,CEA≥1.855μg/L and GG genotype carrying ABCG2 rs2032582 locus were independent risk factors for postoperative recurrence of breast cancer(P<0.05),and ER/PR positive was independent protective factor for postoperative recurrence of breast cancer(P<0.05).The combination of GG genotype,CA153 and CEA at rs2032582 of ABCG2 gene had high predictive efficacy for postoperative recurrence of breast cancer,with an area under the curve of 0.968,predictive sensitivity of 0.958 and specificity of 0.978.Conclusion In addition to tumor size,TNM stage,histological grade,number of lymph node metastases,and ER/PR status,CA153,CEA and GG genotype carrying ABCG2 rs2032582 locus are also risk factors for postoperative recurrence of breast cancer,and their combined efficacy in predicting postoperative recurrence of breast cancer is high,worthy of clinical verification.