血清EGFR、E-cadherin预测乳腺癌新辅助化疗疗效的价值

Value of serum EGFR and E-cadherin as predictive indicators for therapeutic efficacy of neoadjuvant chemotherapy in breast cancer

摘要:

目的 探讨血清表皮生长因子受体（EGFR）、E-钙黏连蛋白（E-cadherin）预测乳腺癌新辅助化疗疗效的价值。方法 选取2020年1月—2023年3月绵阳市第三人民医院收治的151例行新辅助化疗的乳腺癌患者。采用多因素逐步Logistic回归模型分析影响因素，采用受试者工作特征（ROC）曲线验证诊断效能。结果 病理完全缓解（pCR）组肿瘤Ⅱ期占比、E-cadherin水平均高于非pCR组，pCR组KI-67抗原表达≥30%占比、癌胚抗原及EGFR水平均低于非pCR组。多因素逐步Logistic回归分析结果显示：肿瘤分期Ⅲ期［O^R=4.899（95% CI：2.016，11.909）］、EGFR水平高［O^R=3.904（95% CI：1.594，9.563）］、E-cadherin水平低［O^R=0.308（95% CI：0.127，0.748）］均为乳腺癌患者新辅助化疗不完全缓解的危险因素（P <0.05）。ROC曲线分析结果显示，EGFR、E-cadherin及联合模型预测新辅助化疗不完全缓解的敏感性分别为69.44%（95% CI：0.517，0.831）、72.22%（95% CI：0.546，0.852）、83.33%（95% CI：0.665，0.930），特异性分别为75.65%（95% CI：0.666，0.830）、70.43%（95% CI：0.611，0.784）、88.69%（95% CI：0.811，0.936）。曲线下面积分别为0.722（95% CI：0.609，0.834）、0.726（95% CI：0.629，0.822）和0.896（95% CI：0.826，0.966）。结论 血清EGFR、E-cadherin联合用于预测乳腺癌新辅助化疗疗效，可提高预测效能。

Abstract:

Objective To analyze the predictive value of serum epidermal growth factor receptor (EGFR) and E-cadherin in predicting treatment response to neoadjuvant chemotherapy for breast cancer.Methods A total of 151 breast cancer patients admitted to the Third People's Hospital of Mianyang City from January 2020 to March 2023 undergoing neoadjuvant chemotherapy were included. Multivariable stepwise logistic regression was used to analyze the influencing factors, and the receiver operating characteristic (ROC) curve was used to verify the diagnostic efficacy.Results The proportion of stage II tumors and the level of E-cadherin in the pCR group were higher than those in the non-pCR group, while the proportion of KI-67 antigen expression ≥30% and the levels of CEA and EGFR were lower in the pCR group than in the non-pCR group. Multivariable stepwise logistic regression analysis showed that stage III tumors [O^R = 4.899 (95% CI: 2.016, 11.909) ], high EGFR levels [O^R = 3.904 (95% CI: 1.594, 9.563) ], and low E-cadherin levels [O^R = 0.308 (95% CI: 0.127, 0.748) ] were all risk factors for incomplete response to neoadjuvant chemotherapy in breast cancer patients (P < 0.05). ROC curve analysis revealed that the sensitivities of EGFR, E-cadherin, and the combined model for predicting incomplete response to neoadjuvant chemotherapy were 69.44% (95% CI: 0.517, 0.831), 72.2% (95% CI: 0.546, 0.852), and 83.33% (95% CI: 0.665, 0.930), respectively, with corresponding specificities being 75.65% (95% CI: 0.666, 0.830), 70.43% (95% CI: 0.611, 0.784), and 88.69% (95% CI: 0.811, 0.936), respectively, and the areas under the curves being 0.722 (95% CI: 0.609, 0.834), 0.726 (95% CI: 0.629, 0.822), and 0.896 (95% CI: 0.826, 0.966), respectively.Conclusion Combined detection of serum EGFR and E-cadherin can improve the predictive performance for the efficacy of neoadjuvant chemotherapy in breast cancer.