乳腺癌血清GDF3、sAxl、anti-CENPF水平预测前哨淋巴结转移的有效性OA
Predictive value of serum GDF3,sAxl,and anti-CENPF for sentinel lymph node metastasis in breast cancer
目的 探讨乳腺癌患者血清生长分化因子3(GDF3)、可溶性Axl(sAxl)、抗着丝粒蛋白F抗体(anti-CENPF)水平与前哨淋巴结(SLN)转移的关系及其临床预测价值.方法 纳入湖州市中心医院就诊的女性乳腺癌患者200例,收集临床资料,根据SLN病理结果分为转移组(SLN+组,93例)和未转移组(SLN-组,107例).对比两组患者的临床病理特征,并比较两组血清传统肿瘤标志物(CEA、CA153)及GDF3、sAxl、anti-CENPF的水平;通过构建多因素logistic回归模型(模型1:临床病理特征+传统肿瘤标志物;模型2:临床病理特征+GDF3、sAxl、anti-CENPF;模型3:模型1联合模型2变量),采用受试者工作特征曲线(ROC)评估不同模型预测SLN转移的效能,经Deleg检验对比Z值发现模型间曲线下面积(AUC)的差异.结果 SLN+组肿瘤最大径、脉管浸润率、组织学Ⅲ级占比以及CEA、CA153、GDF3、sAxl、anti-CENPF水平均高于SLN-组(P＜0.05).多因素logistic回归分析显示:肿瘤最大径、组织学分级、脉管浸润、CEA、CA153、GDF3、sAxl、anti-CENPF均为影响SLN转移独立危险因素(P＜0.05).模型1、模型2、模型3预测乳腺癌SLN转移的AUC值分别为0.781、0.804、0.886,对应特异度分别为70.00％、76.00％、87.00％,敏感性分别为72.00％、78.00％、90.10％,经Deleg检验对比Z值后,结果显示各模型间AUC差异均有统计学意义(P＜0.05).结论 乳腺癌患者血清GDF3、sAxl、anti-CENPF水平与SLN转移密切相关,且均为影响SLN发生转移的危险因素,三者联合临床病理特征及传统肿瘤标志物的检测可显著提升对SLN转移的预测效能.
Objective To investigate the relationship between serum levels of growth differentiation factor 3(GDF3),soluble Axl(sAxl),and anti-centromere protein F antibody(anti-CENPF)and sentinel lymph node(SLN)metastasis in breast cancer patients,and to evaluate their clinical predictive value.Methods A total of 200 female breast cancer patients treated at our hospital were enrolled.Based on pathological SLN results,patients were divided into SLN-positive(SLN+,n=93)and SLN-negative(SLN-,n=107)groups.Clinical and pathological characteristics were compared between the groups,and serum levels of traditional tumor markers(CEA,CA153)and GDF3,sAxl,anti-CENPF were measured.Three multivariate logistic regression models were constructed:Model 1(clinical-patho-logical characteristics+traditional tumor markers),Model 2(clinical-pathological characteristics+GDF3,sAxl,anti-CENPF),and Model 3(combined variables from Models 1 and 2).Receiver operating characteristic(ROC)curves were used to evaluate predictive performance,and DeLong's test was applied to compare the area under the curve(AUC)between models.Results The SLN+group exhibited larger tumor size,higher rates of lymphovascular inva-sion,higher histological grade Ⅲ proportion,and elevated serum CEA,CA153,GDF3,sAxl,and anti-CENPF com-pared to the SLN-group(P＜0.05).Multivariate logistic regression identified tumor size,histological grade,lympho-vascular invasion,CEA,CA153,GDF3,sAxl,and anti-CENPF as independent risk factors for SLN metastasis(P＜0.05).The AUCs for Models 1,2,and 3 were 0.781,0.804,and 0.886,respectively,with corresponding sensitivities of 72.0％,78.0％,and 90.1％and specificities of 70.0％,76.0％,and 87.0％.DeLong's test indicated that differ-ences in AUCs between the models were statistically significant(P＜0.05).Conclusion Serum GDF3,sAxl,and anti-CENPF levels are closely associated with SLN metastasis in breast cancer and represent independent risk factors.Combined assessment of these biomarkers with clinical-pathological features and traditional tumor markers significantly improves the predictive accuracy for SLN metastasis.
倪小锋;邵霞;张明
湖州市中心医院乳腺外科(浙江湖州 313100)湖州市中心医院乳腺外科(浙江湖州 313100)湖州市中心医院乳腺外科(浙江湖州 313100)
医药卫生
乳腺癌前哨淋巴结转移生长分化因子3可溶性Axl抗着丝粒蛋白F抗体预测效能
breast cancersentinel lymph node metastasisgrowth differentiation factor 3soluble Axlanti-centromere protein F antibodypredictive value
《广东医学》 2026 (3)
407-413,7
浙江省科技计划项目(2022C37089)
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