维生素D联合Ki67在三阴性乳腺癌预后中的价值-现代医学

维生素D联合Ki67在三阴性乳腺癌预后中的价值

单位：钦州市第一人民医院肿瘤内科, 广西钦州 535000

分类号：R737.9

出版年·卷·期（页码）：2020·39·第八期（971-977）

摘要：

目的：探讨维生素D联合Ki67在三阴性乳腺癌（TNBC）化疗后患者预后评估中的应用价值。方法：选取2015年1月至2018年12月我院收治的TNBC患者118例为研究对象，分析维生素D、Ki67与总体生存率（OS）、无瘤生存率（DFS）的相关性，及维生素D联合Ki67在TNBC化疗后患者预后评估中的预测作用。结果：118例TNBC患者血清25-（OH）D与TNBC患者的OS、DFS具有正相关（P<0.05），Ki67与TNBC患者的OS、DFS具有负相关（P<0.05）。COX回归分析中，血清25-（OH）D、TNM分期、淋巴结转移及Ki67是TNBC患者OS、DFS的独立影响因素（P<0.05）。预后评估中，血清25-（OH）D联合Ki67评估OS和DFS的AUC分别是0.901和0.917，均较单一指标评估OS和DFS的AUC高（P<0.05）。结论：维生素D缺乏，Ki67（+）是TNBC患者生存预后的独立危险因素，维生素D联合Ki67可能较单一指标预测TNBC化疗后患者生存预后更准确。

Objective: To explore the value of vitamin D combined with Ki67 in prognosis evaluation of patients with triple negative breast cancer (TNBC) after chemotherapy.Methods: 118 patients with TNBC admitted to our hospital from January 2015 to December 2018 were selected as the research objects. The correlation between vitamin D, Ki67 and overall survival rate (OS), tumor-free survival rate (DFS) were analyzed, and the predictive role of vitamin D combined with Ki67 in the prognosis evaluation of patients after TNBC chemotherapy was analyzed.Results: Serum 25-(OH) d was positively correlated with OS and DFS in 118 patients with TNBC (P<0.05), while Ki67 was negatively correlated with OS and DFS (P<0.05). In Cox regression analysis, serum 25-(OH) d, TNM stage, lymph node metastasis and Ki67 were independent influencing factors of OS and DFS in TNBC patients (P<0.05). The AUC of serum 25-(OH) d combined with Ki67 in assessing OS and DFS were 0.901 and 0.917, respectively, which were higher than those of OS and DFS evaluated by single index (P<0.05).Conclusion: Vitamin D deficiency and Ki67 (+) are independent risk factors for survival and prognosis of TNBC patients. Vitamin D combined with ki67 may be more accurate in predicting survival and prognosis of patients with TNBC after chemotherapy than a single index.

参考文献：

[1] FOULKES W D,SMITH I E,REIS-FILHO J S.Triple-negative breast cancer[J].New England Journal Medicine, 2010,363(20):1938-1948.
[2] 张锋,张卓,邹丽娟,等.早期三阴乳腺癌改良根治术后放疗及预后相关因素分析[J].中华放射医学与防护杂志,2018,38(7):510-516.
[3] KAPLAN H G,MALMGREN J A,ATWOOD M K.Triple-negative breast cancer in the elderly:prognosis and treatment[J].The Breast Journal,2017,23(6):630-637.
[4] 曾敬雅,刘英,叶美廷.三阴性乳腺癌新辅助化疗的预后及与血清维生素D水平和Ki-67、PD-L1表达情况的相关性[J].癌症进展,2019,17(11):1279-1281.
[5] 尹志辉,周志伟,刘继勇,等.乳腺癌患者组织多项组化标记物与血清CA153,CA125,CEA,25-OH-D3水平关联性分析模型建立及在预后判断的临床价值[J].现代检验医学杂志,2019,34(3):47-50.
[6] ADAMO B,RICCIARDI G R R,IENI A,et al.The prognostic significance of combined androgen receptor,E-Cadherin,Ki67 and CK5/6 expression in patients with triple negative breast cancer[J].Oncotarget,2017,8(44):76974-76986.
[7] 范晓杰,王心然,岳萌,等.PD-L1在三阴性乳腺癌组织中表达及其与脉管生成的关系[J].中国肿瘤生物治疗杂志,2019,26(11):1229-1234.
[8] 刘伟,李健斌,王涛,等.蒽环类联合紫杉类方案在乳腺癌新辅助化疗中的有效性及安全性评价[J].临床肿瘤学杂志,2016,21(3):228-232.
[9] 于琦,王钢乐.三阴性乳腺癌的辅助治疗进展[J].癌症进展,2018,16(9):21-25.
[10] 黄喜文,吴静娜,吴国武,等.表柔比星、环磷酰胺联合多西他赛新辅助化疗方案对三阴性乳腺癌的疗效观察[J].临床医学工程,2015,22(12):1586-1588.
[11] 胡一迪,谢燊侠,张辉,等.61例三阴性乳腺癌的临床病理特征及预后因素分析[J].中华内分泌外科杂志,2018,12(2):118-123.
[12] 张渤,郝雅婷,刘玉江,等.影响三阴性乳腺癌患者术后的危险因素评估及预后评价[J].中国药物与临床,2016,16(10):1497-1499.
[13] 王一,廖宏伟,宋扬.三阴性乳腺癌患者新辅助化疗过程中血清维生素D、维生素B_(12)、叶酸水平变化与化疗效果的关系[J].山东医药,2017(27):101-103.
[14] 桑蝶,王佳玉,徐兵河,等.Ki67在三阴性和非三阴性乳腺癌中的表达及疗效预后分析[J].中国肿瘤临床与康复,2016,23(2):7-11.
[15] 汪鹏刚.三阴性乳腺癌的临床病理特征及EGFR与VEGF在三阴性乳腺癌中的表达及意义[D].太原:山西医科大学,2016.
[16] 翁剑华,许素真,胡美笑,等.Ki67在三阴性乳腺癌中的表达及意义[J].临床和实验医学杂志,2016,15(2):126-128.
[17] ROBERTSON S,GUSTAV S,DARAI-RAMQVIST E,et al.Prognostic value of Ki67 analysed by cytology or histology in primary breast cancer[J].Journal of Clinical Pathology,2018,71(9):jclinpath-2017-204976.

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