血清CA50和sAxl及VEGF-C检测在乳腺癌前哨淋巴结转移中的预测价值

Prognostic value of serum CA50,sAxl and VEGF-C in sentinel lymph node metastasis of breast cancer

目的探究血清糖类抗原50(CA50)、可溶性酪氨酸蛋白激酶(sAxl)、血管内皮细胞生长因子C(VEGF-C)检测在乳腺癌前哨淋巴结转移中的预测价值。方法选取2020年1月-2022年6月海口市人民医院收治的120例女性乳腺癌患者作为研究对象。收集患者相关资料,检测血清CA50、sAxl、VEGF-C水平,根据患者是否发生癌前哨淋巴结转移将患者分为转移组(n=56)和未转移组(n=64)。分析影响患者出现前哨淋巴结转移的影响因素,并对比两组患者血清CA50、sAxl、VEGF-C水平,通过绘制受试者工作特征(ROC)曲线分析CA50、sAxl、VEGF-C水平对乳腺癌前哨淋巴结转移的预测价值。结果单因素分析结果显示,肿瘤直径、脉管是否浸润、组织学分级是乳腺癌前哨淋巴结转移的危险因素(P均<0.05)。转移组CA50、sAxl、VEGF-C水平分别为(45.46±1.56)U/mL、(62.49±9.86)ng/mL、(522.65±45.32)ng/L,未转移组分别为(43.97±1.48)U/mL、(58.21±10.32)ng/mL、(452.81±41.33)ng/L,差异均有统计学意义(t=5.365、2.321、7.311,P均<0.05)。ROC曲线分析结果显示,血清CA50、sAxl、VEGF-C水平及联合预测乳腺癌前哨淋巴结转移的曲线下面积分别为0.750、0.616、0.891、0.904,灵敏度分别为0.518、0.696、0.857、0.875,特异度分别为0.875、0.578、0.828、0.828。血清CA50、sAxl、VEGF-C水平的最佳截断值分别为45.640、58.945、485.700。结论肿瘤直径、脉管是否浸润、组织学分级均为乳腺癌前哨淋巴结发生转移的影响因素,血清CA50、s Axl、VEGF-C检测对乳腺癌前哨淋巴结转移具有一定的预测价值,三者联合预测的价值更高,可为临床术前制定合理的手术决策提供参考。

Objective To explore the predictive value of serum carbohydrate antigen 50(CA50),solubility AXL(sAxl)and vascular endothelial growth factor C(VEGF-C)in sentinel lymph node metastasis of breast cancer.Methods A total of120 female breast cancer patients admitted to the Haikou People's Hospital from January 2020 to June 2022 were selected as research objects.Relevant data and serum levels of CA50,sAxl and VEGF-C were determined.Patients were divided into metastatic group and non-metastatic group according to whether they had sentinel lymph node metastasis.The factors influencing the occurrence of sentinel lymph node metastasis were analyzed,and the serum levels of CA50,sAxl and VEGF-C in the two groups were compared.The predictive value of CA50,sAxl and VEGF-C for sentinel lymph node metastasis of breast cancer was analyzed by drawing ROC curve.Results The results of factor analysis showed that tumor diameter,vascular invasion and histological grade were risk factors for sentinel lymph node metastasis in breast cancer(all P<0.05).CA50,sAxl,and VEGF-C levels in the metastatic group were(45.46±1.56)U/mL,(62.49±9.86)ng/mL and(522.65±45.32)ng/L,respectively,and those of the no-metastatic group were(43.97±1.48)U/mL,(58.21±10.32)ng/mL and(452.81±41.33)ng/L,respectively;the differences were statistically significant(t=5.365,2.321,7.311,all P<0.05).ROC curve analysis showed that the levels of serum CA50,sAxl,VEGF-C and the area under the curve of joint prediction of sentinel lymph node metastasis in breast cancer were 0.750,0.616,0.891 and 0.904,respectively,with sensitivities of0.518,0.696,0.857 and 0.875 respectively,specificities of 0.875,0.578,0.828 and 0.828,respectively.The best cutoff values of serum CA50,sAxl and VEGF-C levels were 45.640,58.945 and 485.700,respectively.Conclusions The influence factors of tumor diameter,vascular invasion,and histological grade were uniform.Serum CA50,sAxl and VEGF-C had certain predictive value for breast cancer sentinel lymph node metastasis,and the combined prediction value of the three was higher than that of single index,which could provide reference for making reasonable surgical decisions before clinical surgery.