乳腺癌改良根治术后血清sEC、s-CD105水平与复发转移的相关性分析

Correlation analysis of serum sEC and s-CD105 levels with recurrence and metastasis after modified radical mastectomy

摘要:

目的 分析乳腺癌改良根治术后血清可溶性E-钙黏连蛋白（sEC）、可溶性内皮糖蛋白105（s-CD105）水平与复发转移的关系。方法 选取2017年2月—2020年3月在无锡市第二人民医院行乳腺癌改良根治术的124例乳腺癌患者为研究对象。术后测定患者血清sEC、s-CD105水平，并随访3年，统计复发转移情况。比较复发转移组与未复发转移组患者血清sEC、s-CD105水平，采用多因素逐步Logistic回归分析影响乳腺癌改良根治术后复发转移的因素，绘制受试者工作特征（ROC）曲线分析血清sEC、s-CD105预测乳腺癌改良根治术后复发转移的价值。结果 截至随访结束，12例失访，剩余112例患者中复发转移15例。复发转移组患者血清sEC、s-CD105水平均高于未复发转移组（P <0.05）。多因素逐步Logistic回归分析结果显示，肿瘤分期高［O^R=5.171（95% CI：2.128，12.567）］、分化程度低［O^R=4.899（95% CI：2.016，11.909）］、血清sEC水平高［O^R=3.540（95% CI：1.456，8.602）］、血清s-CD105水平高［O^R=3.673（95% CI：1.511，8.927）］均是影响乳腺癌改良根治术后复发转移的危险因素（P <0.05）。ROC曲线分析结果显示，血清sEC、s-CD105单独及联合预测乳腺癌改良根治术后复发转移的敏感性分别为66.67%（95% CI：0.387，0.870）、73.33%（95% CI：0.448，0.910）、86.67%（95% CI：0.584，0.977）；特异性分别为70.10%（95% CI：0.598，0.788）、77.32%（95% CI：0.675，0.850）、85.57%（95% CI：0.766，0.916）；曲线下面积分别为0.734（95% CI：0.639，0.828）、0.747（95% CI：0.645，0.849）、0.892（95% CI：0.825，0.959）。结论 乳腺癌改良根治术后血清sEC、s-CD105水平与复发转移有关，两者联合预测术后复发转移效能良好。

Abstract:

Objective To analyze the relationship between serum soluble E-cadherin (sEC) and soluble endoglin 105 (s-CD105) levels and recurrence and metastasis in patients with breast cancer after modified radical mastectomy.Methods A total of 124 patients with breast cancer who underwent modified radical mastectomy at the Second People's Hospital of Wuxi from February 2017 to March 2020 were selected as the research subjects. After surgery, serum levels of sEC and s-CD105 were measured in patients, and they were followed up for 3 years to record recurrence and metastasis. The serum levels of sEC and s-CD105 were compared between the recurrence and non-recurrence groups. Multifactorial stepwise logistic regression analysis was used to analyze the factors influencing recurrence and metastasis after modified radical mastectomy for breast cancer, and receiver operating characteristic (ROC) curve analysis was used to evaluate the value of serum sEC and s-CD105 in predicting recurrence and metastasis after modified radical mastectomy for breast cancer.Results By the end of the follow-up, 12 patients were lost to follow-up, leaving 112 patients, among whom 15 experienced recurrence and metastasis. The serum levels of sEC and s-CD105 in the recurrence group were higher than those in the non-recurrence group (P < 0.05). Multifactorial stepwise logistic regression analysis showed that high tumor stage [O^R =5.171(95% CI: 2.128,12.567)], low differentiation degree [O^R =4.899(95% CI: 2.016,11.909)], high serum sEC level [O^R =3.540(95% CI: 1.456,8.602)], and high serum s-CD105 level [O^R =3.673(95% CI: 1.511,8.927)] were all risk factors for recurrence and metastasis after modified radical mastectomy for breast cancer (P < 0.05). ROC curve analysis showed that the sensitivity of serum sEC, s-CD105, and their combination in predicting recurrence and metastasis after modified radical mastectomy for breast cancer was 66.67% (95% CI: 0.387, 0.870), 73.33% (95% CI: 0.448, 0.910), and 86.67% (95% CI: 0.584, 0.977), respectively, and the specificity was 70.10% (95% CI: 0.598, 0.788), 77.32% (95% CI: 0.675, 0.850), and 85.57% (95% CI: 0.766, 0.916), respectively. The area under the ROC curve was 0.734 (95% CI: 0.639, 0.828), 0.747 (95% CI: 0.645, 0.849), and 0.892 (95% CI: 0.825, 0.959), respectively.Conclusion Serum levels of sEC and s-CD105 after modified radical mastectomy for breast cancer are associated with recurrence and metastasis, and their combination has good efficacy in predicting postoperative recurrence and metastasis.