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| 血清TFF1 TK1与晚期乳腺浸润性小叶癌患者白蛋白结合型紫杉醇化疗疗效及预后 |
| Relationship between serum TFF1, TK1 and the efficacy and prognosis of albumin-bound paclitaxel chemotherapy in patients with advanced breast invasive lobular carcinoma |
| 投稿时间：2023-09-22 |
| DOI：10.3969/j.issn.1000-0399.2024.11.003 |
| 中文关键词: 晚期 浸润性小叶癌 白蛋白结合型紫杉醇 三叶因子1 胸苷激酶1 疗效 预后 |
| 英文关键词: Advanced stage Invasive lobular carcinoma Albumin-bound paclitaxel Trefoil factor 1 Thymidine kinase 1 Efficacy Prognosis |
| 基金项目:2019年度河北省医学科学研究课题（编号：20190193） |
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| 中文摘要: |
| 目的 研究血清三叶因子1（TFF1）、胸苷激酶1（TK1）与晚期乳腺浸润性小叶癌（ILC）患者白蛋白结合型紫杉醇化疗疗效和预后的关系。方法 选取2018年4月至2020年7月邯郸市中心医院诊治的97例晚期ILC患者纳入ILC组，以同期我院诊治的70例女性乳腺良性疾病患者纳入良性对照组，70例健康体检的女性志愿者纳入健康对照组。检测并比较3组研究对象血清TFF1、TK1水平。比较不同临床病理特征ILC患者血清TFF1、TK1水平差异；多因素logistic回归分析影响化疗疗效的因素；Kaplan-Meier曲线分析不同血清TFF1、TK1表达对晚期ILC患者预后的影响。结果 ILC组患者血清TFF1、TK1水平高于良性对照组及健康对照组，差异有统计学意义（P=0.05）。组织学分级Ⅲ级、肿瘤最大径＞4 cm的ILC患者血清TFF1、TK1水平高于组织学分级Ⅰ～Ⅱ级、肿瘤最大径≤4 cm患者，差异具有统计学意义（P＜0.05）。根据化疗后疗效分为有效组51例，无效组46例。无效组患者组织学分级Ⅲ级比例、血清TFF1、TK1水平高于有效组，差异有统计学意义（P＜0.05），组织学分级Ⅲ、血清TFF1、TK1水平是影响ILC患者化疗疗效的独立危险因素（OR=1.885、1.716、1.205 ；P＜0.001、0.017、0.011）。TFF1高表达组和低表达组患者的3年生存率分别为44.19%（19/43），72.22%（39/54）；TK1高表达组和低表达组患者的3年生存率分别为43.48%（20/46），74.51%（38/51）。TFF1、TK1高表达组患者3年累积生存率分别低于TFF1、TK1低表达组，差异具有统计学意义（P＜0.05）。结论 晚期ILC患者血清TFF1、TK1水平升高，两者水平升高是影响白蛋白结合型紫杉醇化疗疗效的危险因素，且与晚期ILC患者预后密切相关。 |
| 英文摘要: |
| Objective To study the relationship between serum trefoil factor 1 (TFF1), thymidine kinase 1 (TK1) and the efficacy and prognosis of albumin-bound paclitaxel chemotherapy in patients with advanced breast invasive lobular carcinoma (ILC). Methods A total of 97 advanced ILC patients who were diagnosed and treated in Handan Central Hospital from April 2018 to July 2020 were included in ILC group, 70 patients with benign breast diseases who were diagnosed and treated in our hospital during the same period were included in benign control group, and 70 healthy female volunteers were included in healthy control group. Serum TFF1 and TK1 levels were detected and compared among the three groups. The differences in serum TFF1 and TK1 levels in ILC patients with different clinicopathological features were compared. The factors affecting the efficacy of chemotherapy were analyzed by multivariate Logistic regression analysis. The effects of different serum TFF1 and TK1 expressions on the prognosis of advanced ILC patients were analyzed by Kaplan-Meier curve. Results The serum levels of TFF1 and TK1 in ILC group were higher than those in the benign control group and healthy control group, and the differences were statistically significant (P<0.05). The levels of serum TFF1 and TK1 in ILC patients with histological grade Ⅲ and maximum tumor diameter>4 cm were higher than those in patients with histological grade I～Ⅱ and maximum tumor diameter≤4 cm, and the differences were statistically significant (all P<0.05). According to the therapeutic effect after chemotherapy, there were 51 cases in the effective group and 46 cases in the ineffective group. The proportion of histological grade Ⅲ and serum TFF1 and TK1 levels in ineffective group were higher than those in the effective group, with statistically significant differences (all P<0.05), and histological grade Ⅲ and serum TFF1 and TK1 levels were independent risk factors affecting the chemotherapy efficacy of ILC patients (OR=1.885, 1.716, 1.205; P<0.001, 0.017, 0.011). The 3-year survival rates of patients in TFF1 high expression group and low expression group was 44.19% (19/43) and 72.22% (39/54) respectively. The 3-year survival rates of patients in TK1 high expression group and low expression group were 43.48% (20/46) and 74.51% (38/51) respectively. The 3-year cumulative survival rate of patients in the high expression group of TFF1 and TK1 was lower than that in the low expression group of TFF1 and TK1 respectively, with statistical significance (P<0.05). Conclusion The levels of serum TFF1 and TK1 in advanced ILC patients are increased, which are risk factors affecting the efficacy of albumin-bound paclitaxel chemotherapy, and it is closely related to the prognosis of advanced ILC patients. |
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