临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
Journal of Clinical and Experimental Medicine
2015年
18期
1512-1515
,共4页
印滇%王亚非%杨莉%王以浪
印滇%王亞非%楊莉%王以浪
인전%왕아비%양리%왕이랑
乳腺癌%人乳腺珠蛋白%微转移%酶联免疫吸附测定%ROC 曲线
乳腺癌%人乳腺珠蛋白%微轉移%酶聯免疫吸附測定%ROC 麯線
유선암%인유선주단백%미전이%매련면역흡부측정%ROC 곡선
Breast cancer%Human mammaglobin%Micro - metastasis%Enzyme - linked immuno sorbent aasay%ROC curve
目的：探讨血清人乳腺珠蛋白（hMAM）水平与乳腺癌早期诊断和癌微转移的相关性及其临床意义。方法采用酶联免疫吸附试验（ELISA）分别检测64例乳腺癌患者、32例其他癌患者（直肠癌、胃癌、卵巢癌、前列腺癌患者各8例）、34例良性乳腺相关疾病肿瘤患者和36例体检正常的女性（正常对照组）的血清人乳腺珠蛋白水平并做比较。将64例乳腺癌患者分别按临床 TNM 分期、雌激素受体（ER）表达程度、腋窝淋巴结的转移程度及绝经与否分组并做比较。通过受试者的工作特征曲线（即 ROC 曲线）确定乳腺癌患者的 hMAM 的 Cut - off 值。结果血清 hMAM 的ROC 曲线面积为0.855，即乳腺癌诊断结果的可信度为85.5%；血清 hMAM 的 Cut - off 值为8.54 ng/ ml，其特异性和敏感度分别为83.2%和75.9%。在血清 hMAM 水平和阳性率的比较中，乳腺癌组明显高于其他三组（ P ﹤0.05），且其他三组间差异无显著性（ P ﹥0.05）。Ⅲ和Ⅳ期乳腺癌患者的血清 hMAM 阳性率（62.50%、75.00%）明显高于Ⅰ和Ⅱ期患者（31.25%、37.50%，P ﹤0.05），但 hMAM 水平无显著性差异（ P ﹥0.05）。存在腋窝淋巴结转移的乳腺癌患者的血清 hMAM 的阳性率（90.91%）明显高于无转移的患者（25.00%）（ P ﹤0.05），但 hMAM 水平无显著性差异（ P ﹥0.05）。乳腺癌患者的血清中是否存在 ER 以及是否绝经对 hMAM 及阳性率均无显著性差异（ P ﹥0.05）。结论乳腺癌临床TNM 分期及腋窝淋巴结转移程度与 hMAM 的表达存在相关性；在乳腺癌高危人群的血清检验中，hMAM 的检测有助于提高乳腺癌早期诊断的临床意义，在诊断乳腺癌早期微转移与治疗中具有关键性作用。
目的：探討血清人乳腺珠蛋白（hMAM）水平與乳腺癌早期診斷和癌微轉移的相關性及其臨床意義。方法採用酶聯免疫吸附試驗（ELISA）分彆檢測64例乳腺癌患者、32例其他癌患者（直腸癌、胃癌、卵巢癌、前列腺癌患者各8例）、34例良性乳腺相關疾病腫瘤患者和36例體檢正常的女性（正常對照組）的血清人乳腺珠蛋白水平併做比較。將64例乳腺癌患者分彆按臨床 TNM 分期、雌激素受體（ER）錶達程度、腋窩淋巴結的轉移程度及絕經與否分組併做比較。通過受試者的工作特徵麯線（即 ROC 麯線）確定乳腺癌患者的 hMAM 的 Cut - off 值。結果血清 hMAM 的ROC 麯線麵積為0.855，即乳腺癌診斷結果的可信度為85.5%；血清 hMAM 的 Cut - off 值為8.54 ng/ ml，其特異性和敏感度分彆為83.2%和75.9%。在血清 hMAM 水平和暘性率的比較中，乳腺癌組明顯高于其他三組（ P ﹤0.05），且其他三組間差異無顯著性（ P ﹥0.05）。Ⅲ和Ⅳ期乳腺癌患者的血清 hMAM 暘性率（62.50%、75.00%）明顯高于Ⅰ和Ⅱ期患者（31.25%、37.50%，P ﹤0.05），但 hMAM 水平無顯著性差異（ P ﹥0.05）。存在腋窩淋巴結轉移的乳腺癌患者的血清 hMAM 的暘性率（90.91%）明顯高于無轉移的患者（25.00%）（ P ﹤0.05），但 hMAM 水平無顯著性差異（ P ﹥0.05）。乳腺癌患者的血清中是否存在 ER 以及是否絕經對 hMAM 及暘性率均無顯著性差異（ P ﹥0.05）。結論乳腺癌臨床TNM 分期及腋窩淋巴結轉移程度與 hMAM 的錶達存在相關性；在乳腺癌高危人群的血清檢驗中，hMAM 的檢測有助于提高乳腺癌早期診斷的臨床意義，在診斷乳腺癌早期微轉移與治療中具有關鍵性作用。
목적：탐토혈청인유선주단백（hMAM）수평여유선암조기진단화암미전이적상관성급기림상의의。방법채용매련면역흡부시험（ELISA）분별검측64례유선암환자、32례기타암환자（직장암、위암、란소암、전렬선암환자각8례）、34례량성유선상관질병종류환자화36례체검정상적녀성（정상대조조）적혈청인유선주단백수평병주비교。장64례유선암환자분별안림상 TNM 분기、자격소수체（ER）표체정도、액와림파결적전이정도급절경여부분조병주비교。통과수시자적공작특정곡선（즉 ROC 곡선）학정유선암환자적 hMAM 적 Cut - off 치。결과혈청 hMAM 적ROC 곡선면적위0.855，즉유선암진단결과적가신도위85.5%；혈청 hMAM 적 Cut - off 치위8.54 ng/ ml，기특이성화민감도분별위83.2%화75.9%。재혈청 hMAM 수평화양성솔적비교중，유선암조명현고우기타삼조（ P ﹤0.05），차기타삼조간차이무현저성（ P ﹥0.05）。Ⅲ화Ⅳ기유선암환자적혈청 hMAM 양성솔（62.50%、75.00%）명현고우Ⅰ화Ⅱ기환자（31.25%、37.50%，P ﹤0.05），단 hMAM 수평무현저성차이（ P ﹥0.05）。존재액와림파결전이적유선암환자적혈청 hMAM 적양성솔（90.91%）명현고우무전이적환자（25.00%）（ P ﹤0.05），단 hMAM 수평무현저성차이（ P ﹥0.05）。유선암환자적혈청중시부존재 ER 이급시부절경대 hMAM 급양성솔균무현저성차이（ P ﹥0.05）。결론유선암림상TNM 분기급액와림파결전이정도여 hMAM 적표체존재상관성；재유선암고위인군적혈청검험중，hMAM 적검측유조우제고유선암조기진단적림상의의，재진단유선암조기미전이여치료중구유관건성작용。
Objectine To explore the correlation of serum level of human mammaglobin(hMAM)with early diagnosis and micro - metas-tasis of breast cancer and to study the clinical significance of hMAM. Methods The serum levels of hMAM in 64 patients with breast cancer,32 patients with other cancers(8 patients with prostate cancer,8 patients with gastric cancer,8 patients with ovarian cancer and 8 patients with color-ectal cancer),34 patients with benign breast disease and 36 healthy females(control group)were determined by enzyme linked immunosorbent as-say(ELISA)and their results were analyzed. These 64 patients with breast cancer were classified by TNM staging,they were grouping according to the existence of expression of estrogen receptor(ER),metastasis in axillary lymph nodes and menopause. The cut - off value of serum level of hMAM in patients with breast cancer was determined by receiver operating characteristic(ROC)curve. Results The area under ROC curve of serum level of hMAM was 0. 855,and the reliability of diagnosis in breast cancer was 85. 5%[95% confidence interval( CI):72. 6% ~ 92. 4% ]. When the cut - off value of hMAM was 8. 54 ng/ ml,the respective specificity and sensitivity were 83. 2% and 75. 9% respectively. Serum level of hMAM and positive rate in breast cancer group was significantly higher than that of benign breast disease group,other cancer group and control group( P ﹤ 0. 05). The difference among benign breast disease group,other cancer group and control group was not statistically significant ( P ﹥ 0. 05). The positive rates of serum level of hMAM in patients with III and IV stages breast cancer(62. 50% and 75. 00% )were signifi-cantly higher than those of patients in I and II stages(31. 25% and 37. 50% ,P ﹤ 0. 05),but there was no difference in levels of hMAM( P ﹥0. 05). The positive rate of serum hMAM in patients with breast cancer associated with metastasis in axillary lymph nodes(90. 91% )was signifi-cantly higher than those without metastasis(25. 00% ,P ﹤ 0. 05),but the difference in serum level of hMAM was not significant( P ﹥ 0. 05). Regardless of whether existed ER expression and menopause,serum level of hMAM and positive rate in patients with breast cancer had no differ-ence( P ﹥ 0. 05). with those without metastasis(25. 00% ,P ﹤ 0. 05),but the difference in serum level of hMAM was not significant( P ﹥ 0. 05). Conclusion There are correlation between clinical TNM staging of patients with breast cancer and the degree of metastatsis in axillary lymph nodes. In screening of breast tumor in high risk female patients,the examination of serum level of hMAM is helpful in early detection of patients with breast cancer. It is also important in early detection of micro - metastasis and early treatment.
