糖尿病伴乳腺癌患者细胞角蛋白19片段抗原21-1水平的变化及其临床意义

发布时间：2018-10-30 17:21

【摘要】：目的探讨细胞角蛋白19片段抗原21-1(CYFRA21-1)在糖尿病伴乳腺癌患者中的变化及临床意义。方法选取糖尿病伴乳腺癌患者(DM+乳腺癌组)103例、单纯糖尿病患者(DM组)98例、单纯乳腺癌患者(乳腺癌组)90例及体检健康女性(NC组)82名。另对DM+乳腺癌组随访2年,根据乳腺癌转移和复发情况分为复发亚组30例和非复发亚组68例。收集各组临床资料,ELISA测定血清CYFRA21-1的表达水平。采用多元逐步回归分析糖尿病伴乳腺癌患者CYFRA21-1水平的影响因素。结果(1)DM+乳腺癌组和DM组FPG、2hPG、FIns、HbA_1c及HOMA-IR高于单纯乳腺癌组和NC组,且DM+乳腺癌组2hPG、FIns、HbA_1c及HOMA-IR高于DM组(P0.05);(2)DM+乳腺癌组、DM组及单纯乳腺癌组CYFRA21-1[(8.82±3.83)vs(5.16±2.77)vs(6.38±3.11)vs(1.02±0.33)ng/ml]、游离PSA(FPSA)[(0.06±0.01)vs(0.02±0.01)vs(0.04±0.01)vs(0.01±0.01)ng/ml]、总PSA(TPSA)[(0.69±0.22)vs(0.25±0.11)vs(0.39±0.27)vs(0.13±0.08)ng/ml]、CA153[(64.51±9.11)vs(19.30±2.32)vs(39.77±5.10)vs(7.40±2.59)U/ml]及CEA[(12.79±3.61)vs(2.23±0.50)vs(6.22±1.38)vs(1.57±0.48)ng/ml]水平均高于NC组(P0.05或P0.01)。DM+乳腺癌组各指标均高于DM组和单纯乳腺癌组,而DM组CYFRA21-1、游离前列腺特异性抗原(FPSA)、CA153及CEA低于单纯乳腺癌组(P0.05或P0.01);(3)复发亚组年龄、糖尿病病程、FPG、2hPG、FIns、HbA_1c、HOMA-IR及CYFRA21-1水平均高于非复发亚组(P0.05);(4)多元逐步回归分析显示,年龄、糖尿病病程、HbA_1c是糖尿病伴乳腺癌患者CYFRA21-1水平的影响因素(P=0.000、0.000、0.012)。结论 CYFRA21-1在糖尿病伴乳腺癌患者血清中水平升高,可能是糖尿病伴乳腺癌患者乳腺癌复发的预测指标之一。年龄、糖尿病病程、HbA_1c是糖尿病伴乳腺癌患者CYFRA21-1水平的影响因素。
[Abstract]:Objective to investigate the changes and clinical significance of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) in diabetic patients with breast cancer. Methods 103 patients with DM breast cancer, 98 patients with simple diabetes mellitus (DM group), 90 patients with breast cancer and 82 healthy women (NC group) were selected. The patients with DM breast cancer were followed up for 2 years and divided into recurrent subgroup (30 cases) and non recurrent subgroup (68 cases) according to the metastasis and recurrence of breast cancer. The clinical data of each group were collected and the expression of serum CYFRA21-1 was determined by ELISA. Multiple stepwise regression analysis was used to analyze the influencing factors of CYFRA21-1 level in patients with diabetes and breast cancer. Results (1) the FPG,2hPG,FIns,HbA_1c and HOMA-IR in DM breast cancer group and DM group were higher than those in simple breast cancer group and NC group, and the levels of FPG,2hPG,FIns,HbA_1c and HOMA-IR in DM breast cancer group were higher than those in DM group (P0.05). (2) CYFRA21-1 in DM breast cancer group, DM group and simple breast cancer group [(8.82 卤3.83) vs (5.16 卤2.77) vs (6.38 卤3.11) vs (1.02 卤0.33) ng/ml]; Free PSA (FPSA) [(0.06 卤0.01) vs (0.02 卤0.01) vs (0.04 卤0.01) vs (0.01 卤0.01 ng/ml], Total PSA (TPSA) [(0.69 卤0.22) vs (0.25 卤0.11) vs (0.39 卤0.27) vs (0.13 卤0.08 ng/ml], CA153 [(64.51 卤9.11) vs (19.30 卤2.32) vs (39.77 卤5.10) vs (7.40 卤2.59 U/ml] and CEA [(12.79 卤3.61) vs (2.23 卤0.50) vs (6.22 卤1.38) vs (1.57 卤0.48)] The level of ng/ml was higher than that of NC group (P0.05 or P0.01). DM breast cancer group) than that of DM group and simple breast cancer group (P0.05 or P0.01). The (FPSA), CA153 and CEA of CYFRA21-1, free prostate specific antigen in DM group were lower than those in simple breast cancer group (P0.05 or P0.01). (3) the age, the course of diabetes, the levels of FPG,2hPG,FIns,HbA_1c,HOMA-IR and CYFRA21-1 in the recurrent subgroup were higher than those in the non-recurrent subgroup (P0.05). (4) multiple stepwise regression analysis showed that age, course of diabetes and HbA_1c were the influencing factors of CYFRA21-1 level in patients with diabetes and breast cancer (P < 0.0000.000 / 0.012). Conclusion the elevated level of CYFRA21-1 in the serum of patients with diabetes and breast cancer may be one of the predictors of breast cancer recurrence in patients with diabetes and breast cancer. Age, course of diabetes, and HbA_1c were the influencing factors of CYFRA21-1 level in patients with diabetes and breast cancer.
【作者单位】：武威市人民医院门诊部;武威市人民医院内科;武威市人民医院检验科;武威市肿瘤医院检验科;南阳市中心医院肿瘤一科;
【分类号】：R587.1;R737.9

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