摘要
目的:探讨超声造影(CEUS)联合血清过氧化物还原蛋白6(PRDX6)、潜在转化生长因子β结合蛋白2(LTBP2)在乳腺癌(BC)前哨淋巴结转移(SLNM)预测中的应用价值。方法:选取2022年1月至2024年6月经病理确诊的BC患者116例为研究对象,所有患者术前均接受CEUS检查;酶联免疫吸附法(ELISA)测定血清PRDX6、LTBP2水平,术中进行前哨淋巴结活检(SLNB)及病理检查。根据是否发生SLNM将116例BC患者分为转移组(n=46)和未转移组(n=70);比较转移组与未转移组BC患者一般资料及血清PRDX6、LTBP2水平;受试者工作特征(ROC)曲线分析CEUS、血清PRDX6、LTBP2单独及联合检测对BC患者SLNM的预测效能。结果:转移组与未转移组BC患者在年龄、BMI、绝经情况、肿瘤位置方面比较差异均无统计学意义(P>0.05),在肿瘤直径、T分期、脉管浸润、ER状态方面差异显著(P<0.05);以病理检查结果为“金标准”,CEUS诊断SLNM的灵敏度和特异度分别89.13%(41/46)、88.57%(62/70),准确度为88.79%(103/116),且CEUS与“金标准”具有较高的一致性(Kappa=0.768,P<0.05);转移组患者血清PRDX6、LTBP2水平均显著高于未转移组(P<0.05);ROC曲线结果显示,PRDX6诊断SLNM的敏感度和特异度分别91.3%、82.7%,LTBP2诊断SLNM的敏感度和特异度分别为71.7%、63.1%;CEUS联合血清PRDX6、LTBP2诊断SLNM的敏感度和特异度分别为91.3%、82.7%,三者联合诊断的AUC均显著高于CEUS、血清PRDX6、LTBP2单独测定(Z=2.548、2.205、1.990,P均<0.05)。结论:CEUS联合血清PRDX6、LTBP2对BC患者SLNM具有较高的预测价值,可为BC的临床诊疗提供重要参考依据。
Objective:To investigate the value of contrast-enhanced ultrasound(CEUS)combined with serum peroxide-reducing protein 6(PRDX6)and potential transforming growth factor β binding protein 2(LTBP2)in the prediction of sentinel lymph node metastasis(SLNM)in breast cancer(BC).Methods:A total of 116 BC patients diagnosed by pathology from January 2022 to June 2024 were selected as the study subjects,and all patients underwent CEUS examination before surgery.Enzyme-linked immunosorbent assay(ELISA)was used to measure serum PRDX6 and LTBP2 levels,and sentinel lymph node biopsy(SLNB)and pathological examination were performed during surgery.According to the occurrence of SLNM,116 patients with BC were divided into a metastatic group(n=46)and a non-metastatic group(n=70).The general data and serum PRDX6 and LTBP2 levels of BC patients in the metastatic group and the non-metastatic group were compared.The receiver operating characteristic(ROC)curve was used to analyze the predictive performance of CEUS,serum PRDX6 and LTBP2 alone and in combination with the detection of SLNM in BC patients.Results:There were no significant differences in age,BMI,menopause,and tumor location between the metastatic group and the non-metastatic group in BC patients(P>0.05),but there were significant differences in tumor diameter,T stage,vascular invasion,and ER status(P<0.05).The sensitivity and specificity of CEUS in the diagnosis of SLNM were 89.13%(41/46)and 88.57%(62/70),respectively,and the accuracy was 88.79%(103/116),respectively,and CEUS was highly consistent with the"gold standard"(Kappa=0.768,P<0.05).The serum levels of PRDX6 and LTBP2 in the metastatic group were significantly higher than those in the non-metastatic group(P<0.05).The results of ROC curves showed that the sensitivity and specificity of PRDX6 in the diagnosis of SLNM were 91.3%and 82.7%,respectively,and the sensitivity and specificity of LTBP2 in the diagnosis of SLNM were 71.7%and 63.1%,respectively.The sensitivity and specificity of CEUS combined with serum PRDX6 and LTBP2 in the diagnosis of SLNM were 91.3%and 82.7%,respectively,and the AUC of the combined diagnosis was significantly higher than that of CEUS,serum PRDX6 and LTBP2 alone(Z=2.548,2.205,1.990,P<0.05).Conclusion:CEUS combined with serum PRDX6 and LTBP2 has high predictive value for SLNM in patients with BC,which can provide an important reference for clinical diagnosis and treatment of BC.
作者
李娟
高婧钰
程艳
周莹
晏如意
LI Juan(The First People's Hospital of Qujing,Yunnan Qujing 655000,China)
出处
《河北医学》
2025年第7期1215-1219,共5页
Hebei Medicine
基金
云南省卫生健康委临床医学中心2022-2024年建设项目,(编号:202201AF190147)。
关键词
乳腺癌
超声造影
前哨淋巴结转移
过氧化物还原蛋白6
潜在转化生长因子β结合蛋白2
Breast cancer
Contrast-enhanced ultrasonography
Sentinel lymph node metastasis
Peroxiredoxin-6
Latent transforming growth factor binding protein 2
