血清HAS2、GDF3及CEACAM1在乳腺癌患者行根治术前后的变化特征及其与术后切口部位感染、局部复发的相关性分析

Changes of serum HAS2,GDF3 and CEACAM1 in breast cancer patients before and after radical surgery and their correlation with postoperative incision infection and local recurrence

目的探讨血清透明质酸合成酶2(HAS2)、人生长分化因子3(GDF3)及癌胚抗原相关细胞黏附分子1(CEACAM1)在乳腺癌患者行根治术前后的变化特征及其与术后切口部位感染、局部复发的相关性。方法回顾性选取商洛市中心医院2020年10月至2022年10月收治的乳腺癌患者80例作为研究对象,所有患者均采取根治性手术治疗,对所有患者进行1年随访,分别记录所有患者手术前、术后1周、术后1个月及术后1年HAS2、GDF3及CEACAM1水平变化情况。根据患者术后切口部位感染情况分为感染组(n=15)和非感染组(n=65),分析HAS2、GDF3及CEACAM1与术后切口部位感染的关系,并分析影响术后切口部位感染的危险因素。对所有患者进行1年随访,依照其术后1年内局部复发情况分为复发组(n=20)与非复发组(n=60),分析HAS2、GDF3及CEACAM1与术后局部复发的关系,并分析影响术后局部复发的危险因素。结果乳腺癌患者行根治术后1周、术后1个月及术后1年,HAS2表达水平分别为(211.80±23.82)、(173.69±19.75)、(171.43±22.64)pg/mL,均明显低于手术前[(256.57±38.24)pg/mL],GDF3表达水平分别为(121.23±25.16)、(98.27±13.35)、(95.85±17.84)pg/mL,均明显低于手术前[(157.19±26.24)pg/mL],CEACAM1水平分别为(21.57±5.24)、(34.46±4.46)、(25.34±3.75)μg/L,均高于手术前[(7.80±3.82)μg/L],差异均有统计学意义(P<0.05)。感染组与非感染组患者HAS2水平比较,差异无统计学意义(P>0.05);感染组GDF3表达水平为(166.35±23.61)pg/mL,高于非感染组[(148.83±30.68)pg/mL],CEACAM1水平为(5.65±1.14)μg/L,低于非感染组[(8.15±2.36)μg/L],差异均有统计学意义(P<0.05)。GDF3与术后切口部位感染呈正相关(r=0.425,P<0.05),CEACAM1与术后切口部位感染呈负相关(r=-0.537,P<0.05)。且经多因素Logistics回归分析发现,GDF3为乳腺癌根治术后切口部位感染的独立危险因素(P<0.05)。复发组HAS2、GDF3表达水平分别为(315.63±42.63)pg/mL、(179.46±32.53)pg/mL,均明显高于非复发组[(216.83.±27.85)pg/mL、(143.64±21.63)pg/mL],CEACAM1水平为(3.52±1.06)μg/L,低于非复发组[(6.78±2.62)μg/L],差异均有统计学意义(P<0.05)。HAS2、GDF3与术后局部复发呈正相关(r=0.426、0.634,P<0.05),CEACAM1与术后局部复发呈负相关(r=-0.542,P<0.05)。且经多因素Logistics回归分析发现,HAS2、GDF3为乳腺癌根治术后局部复发的独立危险因素,CEACAM1为乳腺癌根治术后局部复发的保护因素(P<0.05)。结论乳腺癌患者行根治术前后血清HAS2、GDF3及CEACAM1水平均会出现显著变化,且发现GDF3是术后切口部位感染发生的影响因素,HAS2、GDF3及CEACAM1是术后局部复发的影响因素。

Objective To investigate the changes of serum hyaluronic acid synthase 2(HAS2),human growth differentiation factor 3(GDF3)and carcino-embryonic antigen related cellular adhesion molecule 1(CEACAM1)in patients with breast cancer before and after radical surgery,and their correlation with incision site infection and local recurrence.Methods Eighty breast cancer patients admitted to Shangluo Central Hospital from October 2020 to October 2022 were retrospectively selected as the study subjects.All patients were treated with radical surgery.All patients were followed up for one year,and the changes of HAS2,GDF3 and CEACAM1 levels were recorded before surgery,one week after surgery,one month after surgery,and one year after surgery.According to the postoperative incision site infection status of patients,they were divided into infection group(n=15)and non infection group(n=65).The relationship between HAS2,GDF3,and CEACAM1 and postoperative incision site infection was analyzed,and the risk factors affecting postoperative incision site infection were analyzed.Followed up all patients for 1 year and divided them into the recurrence group(n=20)and the non recurrence group(n=60)based on their local recurrence within 1 year after surgery.The relationship between HAS2,GDF3,and CEACAM1 and postoperative local recurrence were analyzed,and the risk factors affecting postoperative local recurrence were analyzed.Results The expression levels of HAS2 at 1 week,1 month and 1 year after radical mastectomy were(211.80±23.82),(173.69±19.75)and(171.43±22.64)pg/mL,respectively,which were significantly lower than those before operation[(256.57±38.24)pg/mL],the expression levels of GDF3 were(121.23±25.16),(98.27±13.35)and(95.85±17.84)pg/mL,respectively,which were significantly lower than those before operation[(157.19±26.24)pg/mL],the levels of CEACAM1 were(21.57±5.24),(34.46±4.46)and(25.34±3.75)μg/L,respectively,which were significantly higher than those before operation[(7.82±0.05)μg/L],the differences were statistically significant(P<0.05).The comparison of HAS2 levels between infected and non infected patients showed no statistically significant difference(P>0.05).The expression level of GDF3 in the infected group was(166.35±23.61)pg/mL,which was higher than that in the non infected group[(148.83±30.68)pg/mL],CEACAM1 was(5.65±1.14)μg/L,which was lower than that in the non infected group[(8.15±2.36)μg/L],and the differences were statistically significant(P<0.05).GDF3 was positively correlated with postoperative incision site infection(r=0.425,P<0.05),and CEACAM1 was negatively correlated with postoperative incision site infection(r=-0.537,P<0.05).Multivariate Logistic regression analysis showed that GDF3 was an independent risk factor for incision site infection after radical surgery for breast cancer(P<0.05);The expression levels of HAS2 and GDF3 in the recurrent group were(315.63±42.63)and(179.46±32.53)pg/mL,which were higher than those in the non recurrent group[(216.83±27.85)and(143.64±21.63)pg/mL],and the CEACAM1 level was(3.52±1.06)μg/L,which was lower than that in the non recurrent group[(6.78±2.62)μg/L],and the differences were statistically significant(P<0.05);HAS2 and GDF3 were positively correlated with postoperative local recurrence(r=0.426,0.634;P<0.05),and CEACAM1 was negatively correlated with postoperative local recurrence(r=-0.542,P<0.05).Multivariate Logistic regression analysis showed that HAS2 and GDF3 were independent risk factors for local recurrence after radical surgery for breast cancer,and CEACAM1 was a protective factor for local recurrence after radical surgery for breast cancer(P<0.05).Conclusion The levels of serum HAS2,GDF3 and CEACAM1 in patients with breast cancer before and after radical surgery will change significantly,and it is found that GDF3 is the influencing factor of incision site infection after surgery,and HAS2,GDF3 and CEACAM1 are the influencing factors of local recurrence after surgery.