摘要
目的探讨同型半胱氨酸(HCY)、凝血功能指标与乳腺癌发病风险及其临床病理特征的关系。方法收集2018年1—12月于天津医科大学肿瘤医院治疗的女性乳腺癌患者(333例)的HCY、凝血功能检测指标及临床病理信息, 选取同期女性乳腺良性病变患者(225例)为对照组。呈正态分布的计量资料的比较采用t检验, D-二聚体(D-D)数据用中位数描述, 采用非参数Mann-WhitneyU检验, 计数资料的比较采用χ^(2)检验, 发病风险分析采用logistic回归分析。结果乳腺癌组患者外周血HCY、纤维蛋白原(Fbg)、蛋白C(PC)、中位D-D水平分别为(13.26±5.24)μmol/L、(2.61±0.83)g/L、(117.55±19.67)%和269.68 ng/ml, 高于对照组[分别为(11.58±0.69)μmol/L、(2.49±0.49)g/L、(113.42±19.82)%和246.98 ng/ml, 均P<0.05], 乳腺癌组凝血酶原时间(PT)、PT[国际标准化比值(INR)]、α2-抗纤溶酶(α2-AP)水平分别为(10.19±0.63)s、0.91±0.07和(110.64±13.93)%, 低于对照组[分别为(10.58±0.65)s、0.93±0.01和(123.81±14.77)%, 均P<0.05]。未绝经乳腺癌患者血清PC、中位D-D水平分别为(112.57±17.86)%和242.01 ng/ml, 高于对照组[分别为(105.31±22.31)%和214.75 ng/ml, 均P<0.05], 未绝经患者PT(INR)、α2-AP水平分别为0.91±0.07和(111.29±12.54)%, 低于对照组[分别为0.98±0.15和(120.17±16.35)%, 均P<0.05]。绝经后乳腺癌患者HCY、中位D-D水平分别为(14.25±5.76)μmol/L和347.53 ng/ml, 高于对照组[分别为(11.67±2.38)μmol/L和328.28 ng/ml, 均P<0.05], 绝经后患者PT、PT(INR)、抗凝血酶Ⅲ(AT-Ⅲ)、α2-AP水平分别为(10.18±0.66)s、0.87±0.09、(97.30±12.84)%和(110.13±14.96)%, 低于对照组[分别为(10.38±0.61)s、0.90±0.08、(102.89±9.12)%和(127.05±12.38)%, 均P<0.05]。T2~4期乳腺癌患者α2-AP、中位D-D水平[分别为(111.69±14.41)%和289.25 ng/ml]高于Tis~1期患者[分别为(108.05±12.37)%和253.49 ng/ml, 均P<0.05];N1~3期患者PT、PT(INR)、Fbg、AT-Ⅲ、α2-AP、中位D-D水平分别为(10.62±0.63)s、0.95±0.06、(3.04±1.52)g/L、(103.21±9.45)%、(118.72±14.77)%和331.33 ng/ml, 高于N0期患者[分别为(10.42±0.58)s、0.93±0.06、(2.52±0.54)g/L、(95.20±13.63)%、(106.91±13.13)%和263.38 ng/ml, 均P<0.05]。未绝经乳腺癌患者中, T2~4期患者HCY水平[(12.63±4.41)μmol/L]高于Tis~1期患者[(10.70±3.49)μmol/L, P=0.010], 凝血酶时间水平[(19.35±0.90)s]低于Tis~1期患者[(19.79±1.23)s, P=0.015], N1~3期患者PT(INR)、Fbg、AT-Ⅲ、α2-AP水平分别为0.97±0.56、(3.37±2.34)g/L、(102.38±8.77)%和(120.95±14.06)%, 高于N0期患者[分别为0.94±0.05、(2.36±0.48)g/L、(94.56±14.37)%和(109.51±11.46)%, 均P<0.05]。绝经后乳腺癌患者中, T2~4期患者AT-Ⅲ、α2-AP水平[分别为(98.48±11.80)%和(111.84±15.35)%]高于Tis~1期[分别为(94.12±14.98)%和(105.49±12.89)%, 均P<0.05];N1~3期患者AT-Ⅲ、α2-AP水平[分别为(103.74±9.94)%和(117.29±15.23)%]高于N0期患者[分别为(95.75±13.01)%和(108.39±14.42)%, 均P<0.05]。结论 HCY、凝血功能异常与乳腺癌发病风险有关, 并与乳腺癌患者T分期及淋巴结转移有关。
Objective To investigate the correlation of homocysteine(HCY)and coagulation function index with the risk of breast cancer and its clinicopathological characteristics.Methods The HCY,coagulation function test index,and clinicopathological information of female breast cancer patients(333 cases)treated in Tianjin Medical University Cancer Hospital from January 2018 to December 2018 were collected,and female patients with benign breast(225 cases)were selected during the same period for the control group.The t-test was used to compare measurement data with normal distribution,D-Dimer data were distributed discreetly and described by median,non-parametric Mann-Whitney U test was used to compare the two groups.The chi-square test was used to compare enumeration data,and the Logistic regression analysis was used for the risk analysis.Results The levels of HCY,fibrinogen(Fbg),protein C(PC),and median D-Dimer(D-D)in peripheral blood of breast cancer patients group[(13.26±5.24)μmol/L,(2.61±0.83)g/L,(117.55±19.67)%,and 269.68 ng/ml,respectively]were higher than those in the control group[(11.58±0.69)μmol/L,(2.49±0.49)g/L,(113.42±19.82)%and 246.98 ng/ml,respectively,P<0.05].The prothrombin time(PT),PT(INR),α2-antiplasmin(α2-AP)levels[(10.19±0.63)s,0.91±0.07 and(110.64±13.93)%,respectively]were lower than those in the control group[(10.58±0.65)s,0.93±0.01 and(123.81±14.77)%,P<0.05].The serum levels of PC and median D-D in premenopausal breast cancer patients[(112.57±17.86)%and 242.01 ng/ml,respectively]were higher than those in the control group[(105.31±22.31)%and 214.75 ng/ml,respectively,P<0.05].The levels of PT(INR),α2-AP[0.91±0.07 and(111.29±12.54)%,respectively]were lower than those of the control group[0.98±0.15 and(120.17±16.35)%,respectively,P<0.05].The levels of HCY and median D-D in postmenopausal breast cancer patients[(14.25±5.76)μmol/L and 347.53 ng/ml,respectively]were higher than those in the control group[(11.67±2.38)μmol/L and 328.28 ng/ml,P<0.05].The levels of PT,PT(INR),antithrombinⅢ(AT-Ⅲ),α2-AP levels[(10.18±0.66)s,0.87±0.09,(97.30±12.84)%and(110.13±14.96)%]were lower than those in the control group[(10.38±0.61)s,0.90±0.08,(102.89±9.12)%,and(127.05±12.38)%,respectively,P<0.05].The levels ofα2-AP and median D-D in T2-4 stage breast cancer patients[(111.69±14.41)%and 289.25 ng/ml,respectively]were higher than those in Tis-1 stage patients[(108.05±12.37)%and 253.49 ng/ml,respectively,P<0.05].The levels of PT,PT(INR),Fbg,AT-Ⅲ,α2-AP,median D-D[(10.62±0.63)s,0.95±0.06,(3.04±1.52)g/L,(103.21±9.45)%,(118.72±14.77)%and 331.33 ng/ml,respectively]in breast cancer patients with lymph node metastasis were higher than those of patients without lymph node metastasis[(10.42±0.58)s,0.93±0.06,(2.52±0.54)g/L,(95.20±13.63)%,(106.91±13.13)%and 263.38 ng/ml,respectively,P<0.05].In non-menopausal breast cancer patients,the level of HCY[(12.63±4.41)μmol/L]in patients with T2-4 stage was higher than that of patients with Tis-1 stage[(10.70±3.49)μmol/L,P=0.010],and the level of thrombin time[(19.35±0.90)s]of patients with T2-4 stage was lower than that of patients with Tis-1 stage[(19.79±1.23)s,P=0.015].The levels of PT(INR),Fbg,AT-Ⅲ,α2-AP[0.97±0.56,(3.37±2.34)g/L,(102.38±8.77)%and(120.95±14.06)%]in patients with lymph node metastasis were higher than those of patients without lymph node metastasis[0.94±0.05,(2.36±0.48)g/L,(94.56±14.37)%and(109.51±11.46)%,respectively,P<0.05].Among postmenopausal breast cancer patients,the levels of AT-Ⅲandα2-AP in T2-4 stage patients[(98.48±11.80)%and(111.84±15.35)%,respectively]were higher than those in patients with the Tis-1 stage[(94.12±14.98)%and(105.49±12.89)%,respectively,P<0.05].The levels of AT-Ⅲandα2-AP in N1-3 stage patients[(103.74±9.94)%and(117.29±15.23)%]were higher than those in N0 stage patients[(95.75±13.01)%and(108.39±14.42)%,P<0.05].Conclusions HCY and abnormal coagulation function are related to the risk of breast cancer,T stage and lymph node metastasis in breast cancer patients.
作者
刘子豪
阎巍
李昉璇
李世霞
刘俊田
Liu Zihao;Yan Wei;Li Fangxuan;Li Shixia;Liu Juntian(Department of Prevention,Tianjin Medical University Cancer Hospital,National Clinical Research Center for Cancer,Tianjin′s Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2022年第6期562-569,共8页
Chinese Journal of Oncology
关键词
乳腺肿瘤
同型半胱氨酸
凝血功能
临床病理特征
Breast neoplasms
Homocysteine
Coagulation function
Clinic pathological characteristics
