摘要
目的 探讨外周血白细胞介素(IL)-6、IL-8、IL-22、鳞状细胞癌抗原(SCC-Ag)和细胞角蛋白21-1片段(CYFRA21-1)在乳腺导管内癌(DCIS)与乳腺浸润性导管癌(IDC)中的表达差异及其对预后的影响。方法 选取126例DCIS患者作为DCIS组, 153例IDC患者作为IDC组,另选取134例健康个体作为对照组。根据TNM分期将IDC组患者分为Ⅰ组(轻度IDC患者, TNM分期Ⅰ+Ⅱ期, 62例)及Ⅱ组(重度IDC患者, TNM分期Ⅲ+Ⅳ期, 91例)。DCIS组和IDC组患者接受放疗或放疗联合化疗治疗。采用酶联免疫吸附试验法测定血清IL-6、IL-8、IL-22水平,采用化学发光微粒子免疫分析法测定SCC-Ag水平,采用化学发光法测定CYFRA21-1水平。比较DCIS组与IDC组患者的临床特征,各组血清IL-6、IL-8和IL-22水平,各组不同疗效患者血清IL-6、IL-8和IL-22水平,各组SCC-Ag和CYFRA21-1水平;分析患者生存情况。结果 与对照组相比, DCIS组及IDC-Ⅰ组、Ⅱ组患者血清IL-6、IL-8和IL-22水平均显著升高(P<0.05);与DCIS组相比, IDC-Ⅰ组、Ⅱ组患者血清IL-6、IL-8和IL-22水平显著升高(P<0.05);与IDC-Ⅰ组相比, IDC-Ⅱ组患者血清IL-6、IL-8和IL-22水平显著升高(P<0.05)。DCIS组、IDC-Ⅰ组、IDC-Ⅱ组完全缓解(CR)+部分缓解(PR)患者血清IL-6、IL-8和IL-22水平均较稳定(SD)+进展(PD)患者明显下降(P<0.05)。DCIS组和IDC组术后复发患者分别为5例和16例, DCIS组和IDC组患者SCC-Ag和CYFRA21-1水平较对照组显著升高(P<0.05)。DCIS组术后复发患者SCC-Ag阳性率为60.0%(3/5), CYFRA21-1阳性率为80.0%(4/5);IDC组术后复发患者SCC-Ag阳性率为62.5%(10/16), CYFRA21-1阳性率为68.8%(11/16)。279例乳腺癌患者1、2、3年存活率分别为44.8%(125/279)、18.6%(52/279)、13.3%(37/279)。SCC-Ag阴性患者的中位生存期为25个月,而SCC-Ag阳性患者的中位生存期为16个月, SCC-Ag阴性患者的中位生存期长于SCC-Ag阳性患者;CYFRA21-1阴性患者的中位生存期为14个月, CYFRA21-1阳性患者的中位生存期为9个月, CYFRA21-1阴性患者的中位生存期长于CYFRA21-1阳性患者。结论 血清IL-6、IL-8、IL-22、SCC-Ag和CYFRA21-1被认为是乳腺癌转移和预后的潜在标志物。
Objective To explore the difference of expression of interleukin(IL-6),IL-8,IL-22,squamous cell carcinoma antigen(SCC-Ag)and cytokeratin-19-fragment(CYFRA21-1)in peripheral blood in ductal carcinoma in situ(DCIS)and invasive ductal carcinoma(IDC)and its influence on prognosis.Methods 126 DCIS patients were selected as the DCIS group,153 IDC patients as the IDC group,and another 134 healthy individuals were selected as the control group.Patients in the IDC group were categorized into groupⅠ(mild IDC patients with TNM stageⅠ+Ⅱ,62 cases)and groupⅡ(severe IDC patients with TNM stageⅢ+Ⅳ,91 cases)according to TNM staging.Patients in the DCIS group and IDC group were treated with radiotherapy or radiotherapy combined with chemotherapy.Serum levels of IL-6,IL-8 and IL-22 were determined by enzyme linked immunosorbent assay,SCC-Ag was determined by chemiluminescence microparticle immunoassay,and CYFRA21-1 was determined by chemiluminescent immunoassay.Comparison was made on clinical characteristics of DCIS and IDC patients,serum IL-6,IL-8 and IL-22 levels in each group,serum IL-6,IL-8 and IL-22 levels in each group of patients with different therapeutic effects,SCC-Ag and CYFRA21-1 levels in each group.The survival of patients was analyzed. Results Compared with control group, the serum levels of IL-6, IL-8 and IL-22 in DCIS group, IDC-Ⅰ group and Ⅱ group were significantly increased (P<0.05). Compared with DCIS group, the serum levels of IL-6, IL-8 and IL-22 in IDC-Ⅰ group and Ⅱ group were significantly increased (P<0.05). Compared with IDC-Ⅰ group, the serum levels of IL-6, IL-8 and IL-22 in IDC-Ⅱ group were significantly increased (P<0.05). The serum IL-6, IL-8 and IL-22 of patients with complete response (CR) + partial response (PR) in DCIS group, IDC-Ⅰ group and IDC-Ⅱ group were significantly decreased compared with stable disease (SD) + progressive disease (PD) patients (P<0.05). There were 5 cases of postoperative recurrence in DCIS group and 16 cases in IDC group, respectively, and the levels of SCC-Ag and CYFRA21-1 in DCIS group and IDC group were significantly higher than those in control group (P<0.05). The SCC-Ag positivity rate was 60.0% (3/5) and CYFRA21-1 positivity rate was 80.0% (4/5) in patients with postoperative recurrence in the DCIS group;the SCC-Ag positivity rate in the IDC group was 62.5% (10/16), and the CYFRA21-1 positivity rate was 68.8% (11/16) in patients with postoperative recurrence. The 1-, 2-, and 3-year survival rates of 279 breast cancer patients were 44.8% (125/279), 18.6% (52/279), and 13.3% (37/279), respectively. The median survival of SCC-Ag-negative patients was 25 months, while that of SCC-Ag-positive patients was 16 months. The median survival time of SCC-Ag-negative patients was longer than that of SCC-Ag-positive patients. The median survival of CYFRA21-1- negative patients was 14 months, while that of CyFRA21-1-positive patients was 9 months. The median survival of CyFRA21-negative patients was longer than that of CyFRA21-1-positive patients. Conclusion Serum IL-6, IL-8, IL-22, SCC-Ag, and CYFRA 21-1 were considered as potential markers in the metastasis and prognosis of breast cancer.
作者
王海燕
杨宪鲁
汤华晓
于洋
梁晓玲
高胜海
WANG Hai-yan;YANG Xian-lu;TANG Hua-xiao(Department of Pathology,Weihai Women and Children's Hospital,Weihai 264200,China)
出处
《中国实用医药》
2024年第11期78-82,共5页
China Practical Medicine
基金
山东省医药卫生科技发展计划项目(项目编号:2018WS109)。
关键词
乳腺导管内癌
乳腺浸润性导管癌
血清因子
表达
预后
Breast ductal carcinoma in situ
Breast invasive ductal carcinoma
Serum factors
Expression
Prognosis
