血清hMAM、HER2、UBE2C联合检测对乳腺癌腋窝淋巴结转移的诊断价值

Diagnostic value of serum hMAM,HER2 and UBE2C for ax⁃illary lymph node metastasis of breast cancer

目的:探究血清人乳腺珠蛋白(hMAM)、人类表皮生长因子受体2(HER2)、泛素结合酶2C(UBE2C)联合检测对乳腺癌腋窝淋巴结转移的诊断价值。方法:选取2022年3月—2024年3月收治的乳腺癌患者90例,根据病理检查结果是否发生腋窝淋巴结转移分为转移组(n=40)和非转移组(n=50),收集患者的一般临床资料,多因素Logistic回归分析乳腺癌发生腋窝淋巴结转移的影响因素,绘制受试者工作特征(ROC)曲线分析hMAM、HER2、UBE2C对乳腺癌腋窝淋巴结转移的诊断价值,Pearson法分析hMAM、HER2、UBE2C与肿瘤标志物血清白蛋白19(CK19)、癌胚抗原(CEA)及三者间相关性。结果:转移组T_(3)+T_(4)期患者及肿瘤直径>3 cm患者占比显著高于非转移组(P<0.05),转移组水平显著高于非转移组(P<0.05);与非转移组相比,转移组血清hMAM、HER2、UBE2C水平均显著升高(P<0.05);CEA、hMAM、HER2、UBE2C水平升高均为影响乳腺癌发生腋窝淋巴结转移的危险因素(P<0.05);ROC曲线结果显示,hMAM、HER2、UBE2C预测乳腺癌发生腋窝淋巴结转移的AUC分别为0.821、0.815、0.819,三者联合的AUC为0.914,显著高于hMAM(Z=2.070,P=0.038)、HER2(Z=2.072,P=0.038)、UBE2C(Z=1.987,P=0.047)单独诊断。hMAM、HER2、UBE2C与肿瘤检测标志物均呈正相关(P<0.05),且三者之间也均互为正相关(P<0.05)。结论:乳腺癌腋窝淋巴结转移患者的血清hMAM、HER2、UBE2C水平升高,三者联合检测对乳腺癌腋窝淋巴结转移具有一定辅助预测价值,可能作为乳腺癌腋窝淋巴结转移潜在的生物标志物。

Objective:To explore the diagnostic value of serum human mammaglobin(hMAM),human epidermal growth factor receptor 2(HER2)and ubiquitin conjugating enzyme 2C(UBE2C)for axillary lymph node metastasis of breast cancer.Methods:Ninety patients with breast cancer admitted to Army 81st Group Hospital from March 2022 to March 2024 were collected and separated into metastatic group(n=40)and non-metastatic group(n=50)according to the pathological examination results.General clinical data were collected and analyzed.Multivariate logistic regression was used to analyze the influencing factors of axillary lymph node metastasis in breast cancer patients.ROC curve was drawn to analyze the diagnostic value of hMAM,HER2,UBE2C for axillary lymph node metastasis in breast cancer patients.Pearson method was applied to analyze the correlation between hMAM,HER2,UBE2C and tumor markers.Results:The proportion of T_(3)+T_(4) stage and tumor diameter>3 cm in the metastatic group was higher than that in the non-metastatic group(P<0.05).The serum levels of cytokeratin-19(CK19)and carcinoembryonic antigen(CEA)in the metastatic group were higher than those in the nonmetastatic group(P<0.05).Compared with the non-metastatic group,the serum hMAM,HER2,and UBE2C levels in the metastatic group were greatly increased(P<0.05).Elevated levels of CEA,hMAM,HER2 and UBE2C were all risk factors for axillary lymph node metastasis in breast cancer patients(P<0.05).ROC curve results showed that the AUC predicted by hMAM,HER2,and UBE2C for axillary lymph node metastasis in breast cancer patients was 0.821,0.815,and 0.819,respectively.The AUC of the combination of the three was greatly higher than that of hMAM(Z=2.070,P=0.038),HER2(Z=2.072,P=0.038),and UBE2C(Z=1.987,P=0.047)diagnosed alone.HMAM,HER2,UBE2C were all positively correlated with tumor detection markers(P<0.05),and the three were also positively correlated with each other(P<0.05).Conclusion:The serum levels of hMAM,HER2 and UBE2C in patients with axillary lymph node metastasis of breast cancer are elevated.The combination of the three has a certain auxiliary predictive value for axillary lymph node metastasis of breast cancer,and may be used as a potential biomarker for axillary lymph node metastasis of breast cancer.