乳腺癌组织中LDH-C4与CMKLR1的表达及其与临床病理特征、肿瘤标志物和预后的关系OA

Objective To investigate the expression of lactate dehydrogenase C4(LDH-C4)and chemokine-like receptor 1(CMKLR1)in breast cancer tissues and their relationship with clinical pathological characteristics,tumor markers and prognosis.Methods A prospective cohort study was conducted on 150 patients with breast cancer admitted to the First People's Hospital of Shuangliu District,Chengdu from January 2016 to June 2020.All patients underwent radical mastectomy and cancer tissues and adjacent normal tissues were collected intraoperatively.Immunohistochemical staining was used to detect LDH-C4 and CMKLR1 expression.LDH-C4 and CMKLR1 expression in different tissues was compared,and the relationship between the expression of LDH-C4 and CMKLR1 in cancer tissues and the pathological characteristics,serum tumor markers[carcinoembryonic antigen(CEA),cancer antigen 153(CA153)]of breast cancer patients was analyzed.Follow-up was conducted for 6～60 months.Kaplan-Meier method analysis was performed to analyze the relationship between LDH-C4 and CMKLR1 expression and postoperative progression-free survival(PFS)prognosis.Stratified Cox regression analysis was used to identify factors influencing PFS prognosis,and subgroup analysis of LDH-C4 and CMKLR1 expression with PFS prognosis were performed.Results The positive expression rate of LDH-C4 in breast cancer tissue was 53.33％,significantly higher than the 26.67％in adjacent normal tissue,while the positive expression rate of CMKLR1 was 41.33％,significantly lower than the 89.33％in adjacent normal tissue(x2=22.218,76.083,all P＜0.05).In patients with pathological stage Ⅱ-Ⅲ,lymph node metastasis,CEA＞5.39 μg/L,and CA153＞26.57 U/mL,the positive expression of LDH-C4 was higher,and CMKLR1 positive expression was lower compared to patients with stage I disease,no lymph node metastasis,CEA ≤ 5.39 μg/L,and CA153 ≤ 26.57 U/mL(P＜0.05).During the 6～60 month follow-up,33 patients experienced tumor progression.Kaplan-Meier survival analysis showed that the 5-year overall progression-free survival rate in LDH-C4 positive patients was 65.85％,lower than the 92.06％in negative patients,while CMKLR1 positive patients had a rate of 91.67％,higher than the 67.06％in negative patients(Log-rank x2=11.748,8.832,P＜0.05).Cox regression analysis showed that pathological stage,lymph node metastasis,CEA,CA153 and LDH-C4 expression were independent risk factors for PFS prognosis,while CMKLR1 expression was an independent protective factor(P＜0.05).Stratified Cox proportional hazard regression analysis showed that after adjusting for pathological stage,lymph node metastasis status,CEA and CA153 levels,LDH-C4 positive positively ramained a risk factor for PFS in breast cancer patients(HR=3.082,95％CI:1.889～5.027,P＜0.05),while CMKLR1 positivity was a protective factor for PFS(HR=0.902,95％CI:0.825～0.986,P＜0.05).Conclusion The expression of LDH-C4 and CMKLR1 is closely associated with pathological stage,lymph node metastasis and serum tumor markers of breast cancer,Together,they constitute a powerful risk network affecting postoperative PFS prognosis and provide a novel theoretical framework for clinical prognostic assessment and precision management after surgery.