乳腺癌改良根治术患者血清CYFRA21-1、TK1及CA15-3水平变化及其与术后复发的相关性研究

摘要

目的 探讨乳腺癌改良根治术患者血清细胞角蛋白19片段(cytokeratin 19 fragment,CYFRA21-1)、胸苷激酶1(thymidine kinase 1,TK1)及癌抗原15-3(cancer antigen 15-3,CA15-3)水平变化及其与术后复发的相关性.方法 选取2015年1月-2017年8月成都医学院第一附属医院行乳腺癌改良根治术患者125例作为乳腺癌组,选取同期体检的年龄、性别匹配的健康体检者125例作为对照组,检测乳腺癌组改良根治术前后及对照组血清CYFRA21-1、TK1及CA15-3水平,根据乳腺癌术后有无复发分复发组和未复发组,比较2组患者血清CYFRA21-1、TK1及 CA15-3水平.结果 乳腺癌 TNMⅠ期患者CYFRA21-1、TK1、CA15-3水平低于TNMⅡ期、Ⅲa期患者(P<0.05);TNMⅡ期低于Ⅲa期患者,差异有统计学意义(P<0.05);乳腺癌组术后CYFRA21-1、TK1、CA15-3水平低于术前(P<0.05),乳腺癌组手术前后CYFRA21-1、TK1、CA15-3水平均高于对照组,差异有统计学意义(P<0.05);截止随访时间29例复发,复发率23.2%.复发组血清CYFRA21-1、TK1、CA15-3水平显著高于未复发组,差异有统计学意义(P<0.05),Logistic回归分析显示,血清CYFRA21-1、TK1、CA15-3水平与术后复发存在关联性(P<0.05);ROC曲线分析显示,CYFRA21-1、TK1、CA15-3联合预测乳腺癌术后复发的特异度、敏感度高于单一指标检测.结论 乳腺癌改良根治术后血清CYFRA21-1、TK1、CA15-3水平与术后复发有关.%Objective To investigate the changes in levels of serum cytokeratin 19 fragment (CYFRA21-1),thymidine kinase 1(TK1) and cancer antigen 15-3(CA15-3) in patients undergo-ing modified radical mastectomy for breast cancer and their correlation with postoperative recurrence. Methods One hundred and twenty-five patients undergoing modified radical mastectomy for breast cancer in the First Affiliated Hospital of Chengdu Medical College during the period from January 2015 to August 2017 were selected as breast cancer group.One hundred and twenty-five healthy peo-ple of matched age and gender were selected as the control group at the same time. The levels of ser-um CYFRA21-1,TK1 and CA15-3 in the breast cancer group before and after modified radical mas-tectomy were detected. According to the occurrence of recurrence, patients in the breast cancer group were divided into the recurrence group and the non-recurrence group. The serum levels of CYFRA21-1,TK1 and CA15-3 were compared between the two groups. Results Levels of CYFRA21-1,TK1 and CA15-3 in patients with breast cancer at TNM stageⅠwere lower than those at TNM stageⅡand stageⅢa (P<0.05). Levels of CYFRA21-1,TK1 and CA15-3 in breast cancer group after op-eration were lower than those before operation(P<0.05).The levels of CYFRA21-1,TK1 and CA15-3 in breast cancer group before and after operation were all higher than those in the control group(P<0.05). At the end of the follow-up,29 cases with recurrence, the recurrence rate was 23.2%. The serum levels of CYFRA21-1,TK1 and CA15-3 in patients with recurrence were significantly high-er than those without recurrence(P<0.05). Logistic regression analysis showed that the levels of ser-um CYFRA21-1,TK1 and CA15-3 were associated with postoperative recurrence(P<0.05).The ROC curve analysis showed that the specificity and sensitivity of combined CYFRA21-1,TK1 and CA15-3 in predicting recurrence of breast cancer were higher than those of any single index. Conclusion Levels of serum CYFRA21-1,TK1 and CA15-3 is related to recurrence after modified radical mastec-tomy of breast cancer.