摘要
目的研究健康人群、三阴性乳腺癌(TNBC)与非三阴性乳腺癌(NTNBC)患者血清中可溶性E-钙黏蛋白(E-Cad)、表皮生长因子受体(EGFR)的表达和意义。方法选取49例三阴性乳腺癌患者(TNBC组),198例非三阴性乳腺癌患者(NTNBC组)和50例健康人群(非患者组)作为研究对象。采用酶联免疫吸附试验检测血清中E-Cad和EGFR表达水平,免疫组织化学检测FOXA1表达。采用ROC曲线评价血清ECad和EGFR对乳腺癌或TNBC的临床诊断价值,并以Youden指数作为诊断试验的准确度评价指标,分别预测血清中E-Cad和EGFR的诊断界值。结果与非患者组比较,乳腺癌患者E-Cad、EGFR和FOXA1表达升高(P<0.01)。与NTNBC组比较,TNBC组E-Cad表达差异无统计学意义(P>0.05),而EGFR表达升高(P<0.01),且FOXA1表达降低(P<0.01)。E-Cad和EGFR诊断乳腺癌的ROC曲线下面积(AUC)分别为0.965(95%CI:0.944,0.986),0.758(95%CI:0.686,0.830),当E-Cad和EGFR的界值分别为1 010.7和107.9 ng/ml时,Youden指数为0.807和0.385,诊断乳腺癌的敏感性为92.7%和78.5%,特异性为88.0%和60%。EGFR诊断TNBC的ROC曲线下面积为0.776(95%CI:0.703,0.848),界值为139.5ng/ml时,Youden指数为0.473,诊断TNBC的敏感性为79.6%,特异性为67.7%。结论 FOXA1可作为乳腺癌或TNBC的辅助诊断指标;血清E-Cad和EGFR检测可作为诊断乳腺癌的指标,且EGFR可作为TNBC的诊断指标。
Objectives To investigate the association of circulating E-cadherin(E-cad)and epidermal growth factor receptor(EGFR)with pathological behavior of breast cancer.Methods Totally 49 patients diagnosed with triple negative breast cancer(TNBC group),198 patients diagnosed with non-triple negative breast cancer(NTNBC group)and 50 healthy subjects were involved in this study.Concentration of E-Cad and EGFR were obtained by enzyme-linked immunosorbent assay(ELISA)and the expression of FOXA1 was measured by immunohistochemistry.The clinical diagnostic value of serum E-cad and EGFR in breast cancer or TNBC was evaluated by ROC curve.The Youden index was utilized to evaluate the diagnostic threshold of E-cad and EGFR.Results Expression levels of E-Cad,EGFR and FOXA1 in breast cancer patients were significantly increased(P<0.01)compared with healthy volunteers.No statistically significant difference in E-Cad was observed between TNBC group and NTNBC group(P>0.05).Concentration of EGFR increased(P<0.01)while FOXA1 decreased(P<0.01)significantly in TNBC group when compared with NTNBC group.ROC curve showed that AUC of E-Cad and EGFR for breast cancer was 0.965(95%CI:0.944,0.986)and 0.758(95%CI:0.686,0.830),respectively.At the threshold of 1 010.7 ng/ml for E-Cad and 107.9 ng/ml EGFR,the Youden index was 0.807 and 0.385,sensitivity for diagnosis of breast cancer was 92.7%and 78.5%,and the specificity was 88.0%and 60%,respectively.AUC of EGFR for diagnosis of TNBC was 0.776(95%CI:0.703,0.848).At the threshold of 139.5 ng/ml,the largest Youden index was 0.473,the sensitivity was 79.6%,and the specificity was 67.7%.Conclusion E-cad and EGFR can be used as indicators of diagnosis for breast cancer while FOXA1 and EGFR can be a diagnostic candidate for diagnosis of TNBC.
作者
张言敏
孙辉
李玉军
Yan-min Zhang;Hui Sun;Yu-jun Li(Department of Pathology,Qiingdao University School of Medicine,Qiingdao,Shandong 266071,China;Department of Oncology,Weifang People’s Hospital,Weifang,Shandong 261000,China;Department of Pathology,the Affiliated Hospital of Qiingdao University,Shandong,Qiingdao 266000,China)
出处
《中国现代医学杂志》
CAS
2018年第9期50-54,共5页
China Journal of Modern Medicine
关键词
三阴性乳腺癌
E-钙黏蛋白
表皮生长因子受体
叉头框蛋白A1
受试者工作特征曲线
triple-negative breast cancer
e-cadhenrin
epidermal growth factor receptor
fork head box protein a1
receiver operating characteristic curve
