关键词: 乳腺癌, 雌激素受体阳性, 乳腺癌根治术, 可溶性肿瘤坏死因子受体P55, 金属硫蛋白1E, 临床转归

Abstract: Objective  To investigate the effect of serum soluble tumor necrosis factor receptor P55(sTNFR-P55) and metallothionein 1E(MT1E) on the clinical outcome of estrogen receptor(ER) positive breast cancer patients undergoing radical mastectomy.Methods The clinical data of 146 patients with ER positive breast cancer who were treated in our hospital from February 2017 to March 2018 were retrospectively analyzed.According to the clinical outcome of patients after surgery,they were divided into recurrent metastatic group and non-recurrent metastatic group.The clinical data,serum sTNFR-P55 and MT1E levels were compared between patients with recurrent metastatic group and non-recurrent metastatic group.Multivariate Logistic regression analysis was used to analyze the related factors influencing the clinical outcome of ER positive breast cancer patients undergoing radical mastectomy.The receiver operating characteristic curve(ROC) was made,and the area under the curve(AUC) was used to analyze the predictive value of serum sTNFR-P55,MT1E and their combination on the clinical outcome of ER positive breast cancer patients undergoing radical surgery.Results By the end of follow-up,32 of 146 patients with ER positive breast cancer had recurrence and metastasis.Tumor size and levels of tumor necrosis factor- α,carbohydrate antigen 125(CA125),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),tumor stage Ⅲ,serum sTNFR-P55 and MT1E in the recurrent metastatic group were higher than those in the non-recurrent metastatic group(P<0.05).Multivariate Logistic  analysis showed that CYFRA21-1(OR=2.768,95%CI 1.107-6.920),CEA(OR=2.751,95%CI 1.101-6.879),tumor stage Ⅲ(OR=3.611,95%CI 1.444-9.029),sTNFR-P55(OR=3.343,95%CI 1.337-8.361) and MT1E(OR=3.267,95%CI 1.307-8.169) were all related factors affecting the clinical outcome of ER positive breast cancer patients undergoing radical surgery(P<0.05).ROC curve analysis results showed that the sensitivity of serum sTNFR-P55,MT1E and their combination in predicting the clinical outcome of ER positive breast cancer patients undergoing radical surgery was 78.12%(95%CI 59.56-90.06),75.00%(95%CI 56.25-87.87) and 71.88%(95%CI 53.02-85.60),respectively.The specificity was 63.16%(95%CI 53.56-71.85),75.44%(95%CI 66.32-82.80) and 96.49%(95%CI 90.73-98.87),respectively.AUC- was 0.723(95%CI 0.642-0.793),0.760(95%CI 0.682-0.827) and 0.880(95%CI 0.816-0.928) respectively.Conclusion Serum sTNFR-P55 and MT1E are related to the clinical outcome of ER positive breast cancer patients undergoing radical mastectomy,and the combination of serum sTNFR-P55 and MT1E is more effective in predicting the clinical outcome of ER positive breast cancer patients undergoing radical mastectomy.

Key words: breast cancer, estrogen receptor positive, radical mastectomy for breast cancer, soluble tumor necrosis factor receptor P55, metallothionein 1E, clinical outcome