血清骨桥蛋白和白细胞介素17表达与三阴性乳腺癌手术治疗预后的关系

Relationship between serum osteopontin and interleukin-17 expression and prognosis of triple-negative breast cancer after surgical treatment

目的探讨血清骨桥蛋白、白细胞介素17(IL-17)表达与三阴性乳腺癌(TNBC)手术治疗预后的关系。方法收集2018年5月至2021年5月于复旦大学附属中山医院接受手术治疗的102例TNBC患者的临床资料和血清标本,将18例(17.6%)术后3年内发生复发或转移的TNBC患者归入预后不良组,其余84例(82.4%)TNBC患者归入预后良好组。通过剂量-反应关系、交互作用及受试者工作特征曲线(ROC)分析血清骨桥蛋白、IL-17与TNBC手术治疗预后的关系。结果预后不良组血清骨桥蛋白、IL-17水平均高于预后良好组[(99±12)μg/L比(85±11)μg/L、(43±4)ng/L比(37±4)ng/L],差异均有统计学意义(均P<0.05)。经限制性立方样条模型分析显示,血清骨桥蛋白、IL-17与TNBC手术治疗预后均呈非线性曲线型剂量反应关系(均P<0.05),当血清骨桥蛋白、IL-17分别>85.12μg/L、>37.40 ng/L时,TNBC手术治疗不良预后风险随指标水平升高而增加。调整混杂因素后,血清骨桥蛋白、IL-17对TNBC手术治疗预后存在正向交互作用,二者均高表达时预后不良风险是均低表达时的13.000倍,二者同时高表达致预后不良风险是其他位置因子的11.307倍,协同效应为二者单独存在产生效应之和的5.198倍,在二者共存的发生风险中,有75.38%是由二者交互作用所致。绘制ROC曲线,结果显示,血清骨桥蛋白、IL-17及联合预测TNBC手术治疗预后的曲线下面积分别为0.810、0.826、0.891,联合预测价值优于单独预测(均P<0.05)。结论血清骨桥蛋白、IL-17与TNBC手术治疗预后相关,血清骨桥蛋白、IL-17高表达可增加TNBC手术治疗不良预后发生风险,且二者存在正向交互作用,协同增加TNBC手术治疗不良预后风险,应引起临床重视。

Objective To investigate the relationship between serum osteopontin and interleukin-17(IL-17)expression and the prognosis of triple-negative breast cancer(TNBC).Methods The clinical data and serum samples of 102 TNBC patients who underwent surgical treatment in Zhongshan Hospital Affiliated Fudan University from May 2018 to May 2021 were collected.Totally 18(17.6%)TNBC patients who had recurrence or metastasis within 3 years after surgery were classified into the poor prognosis group,and the remaining 84(82.4%)TNBC patients were classified into the good prognosis group.The relationship between serum osteopontin and IL-17 and the prognosis of TNBC after surgery were analyzed by dose-response relationship,interaction and receiver operating characteristic(ROC)curve.Results The levels of serum osteopontin and IL-17 in the poor prognosis group were higher than those in the good prognosis group[(99±12)μg/L vs(85±11)μg/L,(43±4)ng/L vs(37±4)ng/L](both P<0.05).The analysis of restricted cubic spline showed that the serum levels of osteopontin and IL-17 had a non-linear dose-response relationship with the prognosis of TNBC patients treated with surgery(all P<0.05).When the serum levels of osteopontin and IL-17 were>85.12μg/L and>37.40 ng/L,respectively,the risk of poor prognosis increased with the increase of the levels of the indexes.After adjusting the confounding factors,there was a positive interaction between serum osteopontin and IL-17 on the prognosis of TNBC treated with surgery.When both of them were overexpressed,the risk of poor prognosis was 13.000 times as high as that when both were low.When both of them were overexpressed,the risk of poor prognosis was 11.307 times as high as that of other factors.The synergistic effect was 5.198 times of the sum of the effects of the two alone,and 75.38%of the risk of their coexistence was caused by their interaction.ROC curve analysis showed that the area under the curve of serum osteopontin,IL-17 and their combination for predicting the prognosis of TNBC after surgery was 0.810,0.826 and 0.891,respectively.The value of combined prediction was better than that of single prediction(both P<0.05).Conclusions Serum osteopontin and IL-17 are related to the prognosis of TNBC after surgical treatment.High expression of serum osteopontin and IL-17 May increase the risk of poor prognosis of TNBC after surgical treatment.There is a positive interaction between the two factors,which synergistically increases the risk of poor prognosis of TNBC after surgical treatment,which should be paid attention to in clinical practice.