摘要
目的:研究术前多项外周血指标检测在乳腺肿块诊断及乳腺癌患者预后评估中的价值。方法:对2016年1月—2017年4月期间在南通大学附属医院接受乳腺肿物切除术的200例女性患者的临床资料进行回顾性分析,根据术后病理学检查结果将患者分为良性组和乳腺癌组,各100例。绘制受试者工作特征曲线找出各项指标用于诊断乳腺癌的最佳临界值,并进一步利用Kaplan-Meier、Log-Rank检验及Cox多因素生存分析等方法探究各项外周血指标在乳腺癌鉴别诊断及预后评估中的作用。结果:(1)两组患者单核细胞计数(absolute monocyte count,AMC)、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,Fib)、D-二聚体(Ddimer,D-D)及乳酸脱氢酶(lactate dehydrogenase,LDH)比较差异均有统计学意义(均P<0.05)。(2)AMC、PT、APTT、D-D与乳腺癌患者预后相关(均P<0.05)。(3)多因素生存分析提示AMC升高(P<0.001,HR=10.871)和APTT缩短(P=0.005,HR=0.215)是乳腺癌患者无进展生存期降低和不良预后的有效预测因子。结论:(1)AMC、PT、APTT、Fib、D-D、LDH等外周血指标可以帮助对乳腺肿块的鉴别诊断。(2)术前AMC升高和APTT缩短有作为乳腺癌患者预后预测指标的价值。
Objective:To study the value of preoperative peripheral blood indices in the diagnosis of breast masses and the prognosis of breast cancer patients.Methods:The data of 200 women who underwent breast tumor resection in Hospital Affiliated of Nantong University from January 2016 to April 2017 were retrospectively analyzed.According to postoperative pathological findings,the patients were divided into benign group and breast cancer group.The receiver operating characteristic curve was drawn to find out the best threshold for diagnosing breast cancer.Further,Kaplan-Meier,Log-Rank test and Cox multivariate survival analysis were used to explore the role of peripheral blood markers in differential diagnosis and prognosis evaluation of breast cancer.Results:(1)The comparison between the two groups showed that there were statistically significant differences in absolute monocyte count(AMC),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib),D-dimer(D-D),lactate dehydrogenase(LDH)(all P<0.05).(2)AMC,PT,APTT and D-D were associated with the prognosis of breast cancer patients(P<0.05).(3)multivariate survival analysis showed that AMC increased(P<0.001,HR=10.871)and APTT shortened(P=0.005,HR=0.215)is an effective predictor of progression-free-survival reduction and poor prognosis in patients with breast cancer.Conclusion:(1)AMC,PT,APPT,Fib,D-D,LDH and other indicators can help the differential diagnosis of breast masses.(2)Preoperative AMC elevation and APTT shortening can be used as predictors of prognosis in patients with breast cancer.
作者
曹薛弦
茅国新
徐榕蔓
储建华
CAO Xuexian;MAO Guoxin;XU Rongman;CHU Jianhua(Department of Oncology Radiotherapy Center,Changshu NO.2 People′s Hospital,Jiangsu Province,Changshu 215500;Department of Oncology,the Affiliated Hospital of Nantong University;Department of Oncology,Haian People′s Hospital,Jiangsu Province)
出处
《南通大学学报（医学版）》
2022年第6期523-526,共4页
Journal of Nantong University(Medical sciences)
基金
江苏省卫健委面上课题(H2017070)
江苏省第五期“333高层次人才培养工程”科研资助项目(BRA2020197)。
关键词
乳腺癌
单核细胞计数
血小板计数
凝血相关指标
乳酸脱氢酶
breast cancer
absolute monocyte count
platelet count
coagulation related indicators
lactate dehydrogenase
