切换至 "中华医学电子期刊资源库"
高级检索
中华乳腺病杂志(电子版)

中华乳腺病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (04) : 215 -219. doi: 10.3877/cma.j.issn.1674-0807.2016.04.005

论著

放射治疗后血清YKL-40 变化对乳腺癌患者预后判断的价值
罗宏涛1, 车团结2, 王小虎1,†(), 魏世鸿1, 姜专基3, 张莹2, 刘锐锋1, 董玉梅1, 郭丽云1, 宋海霞1   
  1. 1.730040 兰州,甘肃省肿瘤医院放射治疗科
    2.730030 兰州百源基因科技有限公司
    3.730040 兰州,甘肃省肿瘤医院乳腺科
  • 收稿日期:2016-01-05 出版日期:2016-08-01
  • 通信作者: 王小虎
  • 基金资助:
    甘肃省卫生行业科研计划管理项目(GWGL2010-5)

Prognostic value of serum YKL-40 change after radiotherapy for breast cancer patients

Hongtao Luo1, Tuanjie Che2, Xiaohu Wang1,†(), Shihong Wei, Zhuanji Jiang3, Ying Zhang2, Ruifeng Liu1, Yumei Dong1, Liyun Guo1, Haixia Song1   

  1. 1.Department of Radiotherapy
    2.Baiyuan Genetic Technology Co., Ltd, Lanzhou 730030, China
    3.Department of Breast Surgery, Gansu Provincial Tumor Hospital, Lanzhou 730040, China
  • Received:2016-01-05 Published:2016-08-01
  • Corresponding author: Xiaohu Wang
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

罗宏涛, 车团结, 王小虎, 魏世鸿, 姜专基, 张莹, 刘锐锋, 董玉梅, 郭丽云, 宋海霞. 放射治疗后血清YKL-40 变化对乳腺癌患者预后判断的价值[J/OL]. 中华乳腺病杂志(电子版), 2016, 10(04): 215-219.

Hongtao Luo, Tuanjie Che, Xiaohu Wang, Shihong Wei, Zhuanji Jiang, Ying Zhang, Ruifeng Liu, Yumei Dong, Liyun Guo, Haixia Song. Prognostic value of serum YKL-40 change after radiotherapy for breast cancer patients[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2016, 10(04): 215-219.

目的

探讨放射治疗后血清YKL-40 变化对乳腺癌患者预后判断的价值。

方法

采用抽签法随机选取2011 年6 月至2012 年12 月在甘肃省肿瘤医院乳腺科门诊进行乳腺癌筛查确诊为健康者30 例(健康对照组),以及就诊于放射治疗科的100 例乳腺癌患者进行前瞻性研究。 采用ELISA 法检测健康对照组及乳腺癌患者放射治疗前后血清YKL-40 水平。 采用独立样本t 检验比较健康对照组与抽签法随机抽取的30 例乳腺癌患者之间,以及100 例乳腺癌患者放射治疗前或放射治疗后CEA、CA153 阳性与阴性患者之间YKL-40 水平的差异;采用配对t 检验比较CEA、CA153 阳性或阴性乳腺癌患者放射治疗前与放射治疗后血清YKL-40 水平的差异。 并且,放射治疗后血清YKL-40 升高者与降低者局部复发率及远处转移率的比较采用χ2 检验,生存曲线绘制采用Kaplan-Meier 法,生存率比较采用Log-rank 检验。

结果

(1)30 例乳腺癌患者放射治疗前后血清YKL-40 水平分别为(104.21±22.07) ng/ml 和(90.14±23.85) ng/ml,均高于健康对照组的(49.04±9.61) ng/ml(t=12.491、 8.673,P 均＜0.001)。 100 例乳腺癌患者放射治疗前后血清YKL-40 水平分别为(102.17±22.04) ng/ml 和(91.67±29.18) ng/ml,放射治疗后血清YKL-40 水平逐步下降(t=4.002,P＜0.001)。 (2)CEA 和CA153 阳性患者血清YKL-40 水平在放射治疗后较放射治疗前均明显降低[CEA:(87.26±30.28) ng/ml比(107.23±25.54) ng/ml,CA153:(77.52±31.01) ng/ml 比(108.12±19.95) ng/ml,t=5.443、 4.750,P 均＜0.001]。 (3)无论是放射治疗前,还是放射治疗后,CEA 阳性患者与阴性患者血清YKL-40 水平均接近(t=1.414、-0.992,P=0.164、0.523);而在放射治疗后,CA153 阳性患者血清YKL-40 水平却明显低于CA153 阴性者[(77.52±31.01) ng/ml 比(95.90±27.42) ng/ml,t=-2.559,P=0.015]。 (4) 在100 例乳腺癌患者中,88 例患者放射治疗后血清YKL-40 水平较放射治疗前降低,12 例患者放射治疗后血清YKL-40 水平较放射治疗前升高。 中位随访36 个月(24 ～48 个月),血清YKL-40 降低者局部复发率、远处转移率分别为18.6%(16/88)和13.6%(12/88),均明显低于血清YKL-40 升高者的66.7%(8/12)和50%(6/12)(χ2=11.081、7.157,P=0.001、0.007)。 放射治疗后血清YKL-40 升高者1、2、3 年OS 率分别为91.7%、83.3%、66.7%,而血清YKL-40 降低者1、2、3 年OS 率分别为97.7%、93.2%、86.4%。 血清YKL-40 升高者OS 率明显低于血清YKL-40 降低者(χ2=4.050,P=0.044)。

结论

YKL-40在乳腺癌患者血清中具有较高的表达水平,放射治疗期间联合检测血清YKL-40、CEA 和CA153,对患者预后的评判具有一定价值。

关键词: 乳腺肿瘤, 生物学标记, 糖蛋白类, 放射疗法

Objective

To explore the significance of serum YKL-40 changes after radiotherapy in predicting the prognosis of breast cancer patients.

Methods

From June 2011 to December 2012, we randomly enrolled 30 healthy women from breast cancer screening in Department of Breast Surgery and 100 breast cancer patients treated in Department of Radiotherapy in Gansu Provincial Tumor Hospital for a prospective study. The serum YKL-40 level in healthy women and breast cancer patients was detected by ELISA. Independent-sample t test was used to detect the difference in serum YKL-40 level between 30 healthy women and 30 random breast cancer patients, as well as the difference in serum YKL-40 level of CEA/CA153 positive or negative breast cancer patients before and after radiotherapy in 100 breast cancer patients. Paired-sample t test was used to detect the difference in serum YKL-40 level of CEA/CA153 positive or negative breast cancer patients before and after radiotherapy. χ2 test was used to compare the local recurrence and distant metastasis between patients with serum YKL-40 level elevated and patients with serum YKL-40 level declined after radiotherapy. The survival curve was plotted using Kaplan-Meier and survival rates were compared using Log-rank test.

Results

(1) The serum YKL-40 levels in 30 breast cancer patients were (104.21±22.07) ng/ml and(90.14 ±23.85) ng/ml before and after radiotherapy respectively, significantly higher than (49.04 ±9.61) ng/ml in healthy controls (t = 12.491, 8.673, P ＜0.001), while the serum YKL-40 levels in 100 breast cancer patients were (102.17±22.04) ng/ml and (91.67±29.18) ng/ml before and after radiotherapy respectively,and the serum YKL-40 levels were gradually decreased after radiotherapy (t=4.002,P＜0.001). (2) The serum YKL-40 levels in patients with CEA/CA153 positive after radiotherapy were significantly lower than that before radiotherapy [CEA: (87.26±30.28) ng/ml vs (107.23±25.54) ng/ml,CA153: (77.52±31.01) ng/ml vs (108.12±19.95) ng/ml, t=5.443, 4.750, all P＜0.001]. (3) Before and after radiotherapy, there was no significant difference in serum YKL-40 level between CEA positive and CEA negative breast cancer patients (t=1.414, -0.992; P=0.164, 0.523). After radiotherapy, the serum YKL-40 level in patients with CA153 positive was significantly lower than that in patients with CA153 negative[(77.52±31.01) ng/ml vs (95.90±27.42) ng/ml,t=-2.559,P=0.015]. (4) Among 100 breast cancer patients, the serum YKL-40 level decreased in 88 cases and increased in 12 cases after radiotherapy. Breast cancer patients were followed up for 24 to 48 months (median follow-up of 36 months). Local recurrence and distant metastasis rate were 18.6% (16/88) and 13.6% (12/88) in patients with serum YKL-40 level elevated, significantly higher than 66.7% (8/12) and 50% (6/12) in patients with serum YKL-40 level declined respectively. The OS in patients with serum YKL-40 level elevated was significantly lower than that in in patients with serum YKL-40 level declined (χ2 =11.081, 7.157; P=0.001, 0.007). The 1-, 2- and 3-year survivals were 91.7%, 83.3% and 66.7% in patients with serum YKL-40 level elevated, 97.7%,93.2% and 86.4% in patients with serum YKL-40 level declined respectively. The OS in patients with serum YKL-40 level elevated was significantly lower than that in patients with serum YKL-40 level declined (χ2=4.050,P=0.044).

Conclusion

YKL-40 is highly expressed in breast cancer patients and the combined detection of serum YKL-40,CEA and CA153 during radiotherapy has predictive value in the prognosis of breast cancer patients.

Key words: Breast neoplasms, Biological markers, Glycoproteins, Radiotherapy
表1 乳腺癌患者CEA、CA153 表达与放射治疗前后血清YKL-40 水平的关系
组别 例数 YKL-40(ng/ml,x¯±s)
放射治疗前 放射治疗后
CEA
阳性 31 107.23±25.54 87.26±30.28a
阴性 69 99.90±20.10 93.65±28.67b
t值 1.414 -0.992
P值 0.164 0.523
CA153
阳性 23 108.12±19.95 77.52±31.01c
阴性 77 100.40±22.44 95.90±27.42d
t值 1.581 -2.559
P值 0.112 0.015
表2 乳腺癌患者放射治疗后血清YKL-40 变化与局部复发及远处转移率的关系
YKL-40 总例数 局部复发 远处转移
例数 复发率(%) 例数 转移率(%)
升高 12 8 66.7 6 50.0
降低 88 16 18.6 12 13.6
χ2值 11.081 7.157
P值 0.001 0.007
图1 乳腺癌患者放射治疗后血清YKL-40 变化对OS 率的影响 注:血清YKL-40 升高者OS 率明显低于血清YKL-40 降低者,χ2=4.050, P=0.044
[1]
Kzhyshkowska J, Yin S, Liu T,et al.Role of chitinase-like proteins in cancer[J].Biol Chem,2016,397(3):231-247.
[2]
Kazakova MH, Sarafian VS. YKL-40--a novel biomarker in clinical practice? [J].Folia Med (Plovdiv),2009,51(1):5-14.
[3]
罗宏涛,魏世鸿,王小虎,等.联合检测CA153 和CEA 在乳腺癌复发转移监测中的临床价值[J]. 甘肃医药,2014,33 (10):728-730.
[4]
Johansen JS,Williamson MK,Rice JS,et al. Identification of proteins secreted by human osteoblastic cells in culture[J].J Bone Miner Res,1992,7(5):501-512.
[5]
Bjørn ME, Andersen CL, Jensen MK,et al. Circulating YKL-40 in myelofibrosis a potential novel biomarker of disease activity and the inflammatory state[J].Eur J Haematol,2014,93(3):224-228.
[6]
Shao R, Cao QJ, Arenas RB,et al.Breast cancer expression of YKL-40 correlates with tumour grade, poor differentiation, and other cancer markers[J].Br J Cancer,2011,105(8):1203-1209.
[7]
Anghileri E, Castiglione M, Nunziata R,et al. Extraneural metastases in glioblastoma patients: two cases with YKL-40-positive glioblastomas and a meta-analysis of the literature[J].Neurosurg Rev,2016,39(1):37-45.
[8]
Harving ML, Christensen LH, Ringsholt M, et al. YKL-40 expression in soft-tissue sarcomas and atypical lipomatous tumors: An immunohistochemical study of 49 tumors [J]. Acta Orthop,2014,85(2):195-200.
[9]
杨帅,王伟民,张小鹏,等.血清YKL40 水平与胶质瘤病理分级及预后的相关性研究[J].中国微侵袭神经外科杂志,2014,19(10):437-439.
[10]
尚倩,赵淑萍.YKL-40 和VEGF 在上皮性卵巢癌组织中的表达及其临床意义[J].泰山医学院学报,2014,35(3):171-173.
[11]
Tarpgaard LS,Guren TK,Glimelius B,et al. Plasma YKL-40 in patients with metastatic colorectal cancer treated with first line oxaliplatin-based regimen with or without cetuximab: result from thenordic Ⅶstudy[J].PLoS One,2014,9(2):e87746.
[12]
Francescone RA, Scully S, Faibish M,et al. Role of YKL-40 in the angiogenesis, radioresistance, and progression of glioblastoma[J].Biol Chem,2011,286(17):15 332-15 343.
[13]
Kang EJ, Jung H, Woo OH,et al.YKL-40 expression could be a poor prognostic marker in the breast cancer tissue[J]. Tumour Biol, 2014,35(1):277-286.
[14]
刘敏,陈昌国,马聪,等.CEA、CA153、CA199、CYFR21-1 联合检测在乳腺癌诊断中的意义[J]. 国际检验医学杂志,2014,35(3):320-321.
[1] 李洋, 蔡金玉, 党晓智, 常婉英, 巨艳, 高毅, 宋宏萍. 基于深度学习的乳腺超声应变弹性图像生成模型的应用研究[J/OL]. 中华医学超声杂志（电子版）, 2024, 21(06): 563-570.
[2] 周荷妹, 金杰, 叶建东, 夏之一, 王进进, 丁宁. 罕见成人肋骨郎格汉斯细胞组织细胞增生症被误诊为乳腺癌术后骨转移一例[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 380-383.
[3] 河北省抗癌协会乳腺癌专业委员会护理协作组. 乳腺癌中心静脉通路护理管理专家共识[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 321-329.
[4] 刘晨鹭, 刘洁, 张帆, 严彩英, 陈倩, 陈双庆. 增强MRI 影像组学特征生境分析在预测乳腺癌HER-2 表达状态中的应用[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 339-345.
[5] 张晓宇, 殷雨来, 张银旭. 阿帕替尼联合新辅助化疗对三阴性乳腺癌的疗效及预后分析[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 346-352.
[6] 邱琳, 刘锦辉, 组木热提·吐尔洪, 马悦心, 冷晓玲. 超声影像组学对致密型乳腺背景中非肿块型乳腺癌的诊断价值[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 353-360.
[7] 程燕妮, 樊菁, 肖瑶, 舒瑞, 明昊, 党晓智, 宋宏萍. 乳腺组织定位标记夹的应用与进展[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 361-365.
[8] 涂盛楠, 胡芬, 张娟, 蔡海峰, 杨俊泉. 天然植物提取物在乳腺癌治疗中的应用[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 366-370.
[9] 朱文婷, 顾鹏, 孙星. 非酒精性脂肪性肝病对乳腺癌发生发展及治疗的影响[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 371-375.
[10] 葛睿, 陈飞, 李杰, 李娟娟, 陈涵. 多基因检测在早期乳腺癌辅助治疗中的应用价值[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 257-263.
[11] 高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[12] 韩萌萌, 冯雪园, 马宁. 乳腺癌改良根治术后桡神经损伤1例[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 117-118.
[13] 张志兆, 王睿, 郜苹苹, 王成方, 王成, 齐晓伟. DNMT3B与乳腺癌预后的关系及其生物学机制[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 624-629.
[14] 王玲艳, 高春晖, 冯雪园, 崔鑫淼, 刘欢, 赵文明, 张金库. 循环肿瘤细胞在乳腺癌新辅助及术后辅助治疗中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 630-633.
[15] 赵林娟, 吕婕, 王文胜, 马德茂, 侯涛. 超声引导下染色剂标记切缘的梭柱型和圆柱型保乳区段切除术的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 634-637.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号