【摘要】：目的:通過觀察乳腺癌患者紅細(xì)胞體積分布寬度(RDW)和乳腺癌分子標(biāo)志物即雌激素受體(ER)、孕激素受體(PR)及人類表皮生長因子受體2(HER-2)指標(biāo)的變化,探討其與乳腺癌病變程度的關(guān)系及臨床意義。方法:收集2011年1月至2015年7月在蘭州大學(xué)第一醫(yī)院收治并經(jīng)空芯針穿刺活檢或術(shù)后病理診斷為乳腺癌患者的臨床資料,進(jìn)行回顧性分析,完整記錄患者的臨床基線資料、紅細(xì)胞參數(shù)、生化指標(biāo)以及乳腺癌分子標(biāo)志物檢查結(jié)果。選取體檢的健康女性作為正常對(duì)照組。應(yīng)用SPSS 21.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,將乳腺癌組與正常對(duì)照組及乳腺癌亞組之間的紅細(xì)胞參數(shù)和生化指標(biāo)進(jìn)行比較,同時(shí)對(duì)比各亞組間乳腺癌分子標(biāo)志物是否存在差異,用Logistic回歸分析評(píng)估乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的影響因素。結(jié)果:1.本研究共納入了87例女性乳腺癌患者,按組織學(xué)分類分組:包括浸潤性導(dǎo)管癌76例(87.36%),浸潤性小葉癌8例(9.20%),黏液癌3例(3.45%);按組織學(xué)分級(jí)分組:包括Ⅰ~Ⅱ期48例(55.17%),Ⅲ期33例(37.93%),Ⅳ期6例(6.90%);按腋窩淋巴結(jié)轉(zhuǎn)移與否分組,伴腋窩淋巴結(jié)轉(zhuǎn)移36例(41.38%),不伴腋窩淋巴結(jié)轉(zhuǎn)移51例(58.62%)。2.乳腺癌組的Hb和Alb明顯低于正常對(duì)照組(P0.05),而MCV、RDW和LDL明顯高于正常對(duì)照組(P0.05)。乳腺癌亞組中,伴腋窩淋巴結(jié)轉(zhuǎn)移組Hb明顯低于不伴腋窩淋巴結(jié)轉(zhuǎn)移組(P0.05),而MCV、RDW明顯高于不伴腋窩淋巴結(jié)轉(zhuǎn)移組(P0.05)。Ⅲ期、Ⅳ期RDW明顯高于Ⅰ~Ⅱ期,而Ⅳ期RDW明顯高于Ⅲ期(P0.05)。3.HER-2陽性表達(dá)率與乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移與否具有顯著差異性(P0.05)。HER-2陽性表達(dá)組的RDW明顯高于陰性表達(dá)組;HER-2陽性表達(dá)的乳腺癌患者伴腋窩淋巴結(jié)轉(zhuǎn)移組的RDW明顯高于不伴腋窩淋巴結(jié)轉(zhuǎn)移組(P0.05)。4.Hb和MCV是乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的保護(hù)因子,而RDW和HER-2是危險(xiǎn)因子。且隨著RDW值升高,其每相差一個(gè)等級(jí),乳腺癌患者發(fā)生腋窩淋巴結(jié)轉(zhuǎn)移的危險(xiǎn)增加1.255倍;HER-2陽性表達(dá)的乳腺癌患者發(fā)生腋窩淋巴結(jié)轉(zhuǎn)移的可能性是HER-2陰性表達(dá)者的2.094倍。結(jié)論:1.浸潤性導(dǎo)管癌(非特殊型浸潤性癌)是乳腺癌中最常見的類型。2.RDW升高可作為評(píng)估乳腺癌預(yù)后的指標(biāo)之一。3.RDW和HER-2聯(lián)合分析,可作為評(píng)估乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的預(yù)測指標(biāo)。4.RDW和HER-2水平有望作為乳腺癌腋窩淋巴結(jié)轉(zhuǎn)移的獨(dú)立預(yù)測因素。
[Abstract]:Objective: to observe the changes of erythrocyte volume distribution width (RDW) and breast cancer molecular marker estrogen receptor (ER), progesterone receptor (PR) and human epidermis growth factor receptor 2 (HER-2) in patients with breast cancer. To explore the relationship between breast cancer and the degree of breast cancer and its clinical significance. Methods: from January 2011 to July 2015, the clinical data of patients with breast cancer diagnosed by hollow needle biopsy or postoperative pathology in the first Hospital of Lanzhou University were collected and analyzed retrospectively. the clinical baseline data of the patients were recorded completely. Red blood cell parameters, biochemical indexes and breast cancer molecular markers. Healthy women were selected as normal control group. The erythrocyte parameters and biochemical indexes between breast cancer group and normal control group and breast cancer subgroup were compared by SPSS 21.0 software, and the differences of breast cancer molecular markers among each subgroup were compared at the same time. Logistic regression analysis was used to evaluate the influencing factors of axillary lymph node metastasis in breast cancer. Result: 1. A total of 87 female patients with breast cancer were classified according to histology: 76 cases (87.36%) were invasive ductal carcinoma, 8 cases (9.20%) were invasive lobular carcinoma and 3 cases (3.45%) were mucinous carcinoma. According to the histological grade, there were 48 cases (55.17%) in stage 鈪，

本文編號(hào)：2485052