摘要
目的:探讨轴突生长诱向因子4(Netrin-4)表达水平对乳腺癌(BC)保乳手术患者远期生存的预测价值。方法:选取2012年1月至2014年1月在河北省定州市人民医院腺体外科住院的早期乳腺癌患者134例,采用PCR法测定BC患者癌组织和癌旁组织中Netrin-4的表达水平,受试者工作特征(ROC)曲线分析Netrin-4对BC保乳术患者远期生存的预测价值,Kaplan-Meier法分析Netrin-4表达水平对BC保乳术患者总生存时间的影响,COX回归模型分析影响BC保乳术患者远期生存的独立影响因素。结果:BC患者癌组织中Netrin-4表达水平显著低于癌旁组织(P<0.05)。Netrin-4在TNMⅡ期、淋巴结转移及肿瘤直径≥3 cm患者癌组织中呈低表达(P<0.05),而与性别、年龄和肿瘤类型无关(P>0.05)。ROC曲线分析提示,癌组织Netrin-4对BC患者保乳手术治疗后远期生存具有一定的预测价值。ROC曲线下面积为0.719(95%CI:0.55~0.772),灵敏度为67.6%,特异度为80.3%。多因素COX回归分析显示,Netrin-4低表达为BC患者保乳手术远期生存的危险因素(HR=1.81,95%CI:1.39~2.36)。结论:BC保乳术治疗患者癌组织Netrin-4表达水平与临床病理特征有一定关系,对术后远期生存具有一定预测价值;Netrin-4表达下调可能是BC保乳术治疗患者预后的危险因素。
Objective:To investigate the predictive value of Netrin-4 expression level for long-term survival of breast cancer(BC)patients undergoing breast conserving surgery.Methods:The expression of Netrin-4 in cancer tissues and adjacent tissues of 134 patients with early BC in our hospital from January 2012 to January 2014 was measured by PCR.The predictive value of Netrin-4 on long-term survival of BC breast-conserving patients was analyzed by receiver operating characteristic(ROC)curve.Kaplan-Meier test was used to analyze the effect of Netrin-4 expression on the overall survival of BC breast conserving patients.COX regression model was used to analyze the independent factors influencing the long-term survival of BC breast conserving patients.Results:The expression of Netrin-4 in BC tissues was significantly lower than that in adjacent tissues(P<0.05).Netrin-4 expression was lower in patients with TNM stage II,lymph node metastasis or cancer tissues diameter≥3 cm(P<0.05),but it was not related with sex,age and type of cancer(P>0.05).ROC curve analysis indicated that Netrin-4 in cancer tissues had certain predictive value for long-term survival of BC patients after breast conserving surgery.The area under ROC curve was 0.719(95%CI:0.55-0.772),the sensitivity was 67.6%,and the specificity was 80.3%.Multivariate COX regression analysis showed that low expression of Netrin-4 was an independent risk factor for long-term survival of BC patients undergoing breast conserving surgery(HR=1.81,95%CI:1.39-2.36).Conclusion:The expression level of Netrin-4 in breast cancer tissues is related to the clinicopathological characteristics of BC patients treated with breast conserving surgery,and has certain predictive value for postoperative long-term survival;the low expression of Netrin-4 may be an independent risk factor for the prognosis of the patients.
作者
何文博
He Wenbo(Department of Extracorporeal Glands,Dingzhou People's Hospital,Dingzhou 073000,China)
出处
《广西医科大学学报》
CAS
2019年第12期1946-1949,共4页
Journal of Guangxi Medical University
基金
河北省定州市科技攻关计划资助项目(No.20191749)
