Serum sialyltransferase and 5'-nucleotidase as reliable biomarkers in women with breast cancer

Sialyltransferase and 5'-nucleotidase were measured in the sera of 135 women with breast cancer: 53 undergoing mastectomy for primary cancer and 83 receiving different modalities of palliative therapy for metastatic disease. The objective of this study was to determine whether these enzyme levels were associated with the extent of the disease and whether changes in these enzyme levels could be correlated with success or failure of treatment. Mastectomy caused a rapid fall of elevated enzyme levels to within the normal range in all patients with stage I breast cancer but not in those with stage II or III disease. In women with metastatic disease, elevated enzyme levels fell only in patients responding to treatment. Thus serum sialyltransferase and 5'-nucleotidase activities are reliable biomarkers of breast cancer activity, and serial measurement of these enzyme activities provides a useful tool for the monitoring of disease activity and success or failure of the treatment.     

Enzyme activities in human breast tumor cells and sera

Galactosyltransferase (GalTF), sialyltransferase (SiaTF), fucosyltransferase (FucTF), 5'-nucleotidase (5'Nucl), and ADP-ribosyltransferase (RibTF) were determined in three subcellular fractions of tumor cells and adjacent control tissue from 20 patients with small primary infiltrating ductal adenocarcinomas of the breast. Viable, as pure tumor cell populations as possible were isolated, subfractionated, and their enzyme levels compared to those in the patients' sera. The activities in tumor cells of the three glycosyltransferases were two- to seven-fold higher, whereas 5'-Nucl and RibTF showed reduced activities when compared to adjacent noninvolved tissue. Serum GalTF and SiaTF were slightly elevated in early mammary carcinoma, whereas FucTF, 5'Nucl, and RibTF were decreased in comparison with a control group. The proposed tumor origin of circulating enzymes could not be confirmed. Surprisingly, only for RibTF could a correlation between tumor and serum activity be established; a weak correlation was found for SiaTF. However, no such relationship could be determined for GalTF, FucTF, or 5'Nucl. In conclusion, the enzyme profile of the tumor cell does not, except for RibTF, appear in the serum. Serum enzyme profiles, therefore, do not permit detection of the early stages of breast cancer. A high correlation between RibTF activity and cytosol estrogen and progesterone receptor levels has been determined in tumor cells, possibly indicating slower growing, more differentiated types of breast tumors.     

Clinical evaluation of serum osteocalcin in patients with bone metastasis of breast cancer

Bone metastasis is one of the characteristic behavior of recurrent breast cancer. Usually, X-ray detect and/or bone scintigraphy are used to evaluate bone metastasis. However, false positive cases are occasionally encountered in these modalities. This is a report of the results from the measurement of serum osteocalcin (OC) in breast cancer with bone metastasis. OC is one of the protein dependent on Vitamin K. The results were as follows: 1) Serum levels of OC in 56 patients with primary breast cancer were measured. The mean level of serum OC was significantly higher than that in patients with benign breast disease. But the comparisons in each stage were not statistically significant. 2) The mean serum OC level in patients of primary breast cancer with bone metastasis was higher than that in breast cancer without bone metastasis (p less than 0.05). This was remarkable in the patients of recurrent breast cancer (p less than 0.01). 3) Serum OC levels in bone metastasis patients were increased in group with normocalcemia, while it was normal or decreased in that with hypercalcemia. There was no significant correlation between either serum OC and ALP values, or between serum OC and serum Ca values. The slight positive and reverse correlation were observed between OC and ALP, OC and sCa, respectively. 4) In many cases with bone metastasis, serum OC levels were elevated before bone lesions were detected by bone scintigraphy. 5) In advanced stage of the patients with bone metastasis and hypercalcemia, serum OC level decreased. The increased level of serum OC was maintained when high dose of calcitonin was administered.     

Plasma sialyltransferase as a tumor marker

Neoplastic transformations are accompanied by an alteration in the composition of cell membrane glycoproteins, major structural components of the cell surface. Plasma sialyltransferase enzyme is involved in the transfer of sialic acid residues from cytosine monophosphate (CMP) sialic acid to a suitable acceptor. In the present study plasma sialyltransferase was assayed using a radiometric method, which measured the transfer of radioactivity from (14C) CMP sialic acid to desialated fetuin. Plasma sialyltransferase was measured in 127 normal and 91 cancer patients. The mean plasma sialyltransferase in the normal volunteers was 837 units (CPM/25 microliters plasma/hr). The mean plasma sialytransferase in 26 breast cancer patients, 22 lung cancer patients, 20 colon cancer patients, 5 ovarian cancer patients, 4 cervix cancer patients, 5 pancreas cancer patients, 6 prostate cancer patients, and 3 gastrointestinal tract cancer patients was 1710, 1406, 1344, 1227, 1233, 1406, 1250, and 1426 units, respectively. No significant difference was observed with respect to age. In 32 treated breast cancer patients the mean value was 757 units. Serial determinations in 17 patients correlated well with tumor burden. However, in 2 patients the plasma enzyme level did not correspond to tumor mass. These results indicate that plasma sialyltransferase is significantly elevated in patients with a variety of cancers. Plasma sialyltransferase determination may be useful in the followup of patients with a variety of cancers.     

Evaluation of 5'-nucleotidase as an enzyme marker in ovarian carcinoma

A plasma membrane ectoenzyme in mammalian cells, 5'-nucleotidase, was evaluated as a marker for ovarian carcinoma. Activities of this enzyme were determined in homogenates from normal (N = 17) and malignant ovaries (N = 17), as well as in the sera from control women (N = 35), ovarian cancer patients with active disease (N = 24), and those in clinical remission (N = 9). A significant reduction of the activity of 5'-nucleotidase was observed in tumor homogenates compared with homogenates from normal ovaries. Levels of this enzyme in the sera of ovarian cancer patients were higher than in control women, suggesting the possibility of shedding of this enzyme from the tumor cell surface to the systemic circulation of the host. The diagnostic value of serum 5'-necleotidase levels was compared with another enzyme marker for ovarian carcinoma, viz. serum glycoprotein:galactosyltransferase. The upper limit of normal was set at 2 SD higher than the normal mean. Elevation of serum 5'-nucleotidase was observed in 12/24 (50%) patients with active disease, and 1/9 (11%) patients with clinical remission. In contrast, serum glycoprotein:galactosyltransferase was elevated in all the serum samples from patients with active disease and in none of those with clinical remission. There was some correlation between the serum levels of 5'-nucleotidase and those of glycoprotein:galactosyltransferase (0.01 less than P less than 0.05). Elevation of 5'-nucleotidase in the serum of these patients was not due to liver metastasis. Serum 5'-nucleotidase levels seem to correlate with disease status in some ovarian carcinoma patients, but in general it is inferior to serum glycoprotein:galactosyltransferase as a tumor marker.     

The immunoscintigraphic use of Tc-99m-labelled monoclonal anti-CEA antibodies (BW 431/26) in patients with suspected primary, recurrent and metastatic breast cancer

The discrepancy between serum CEA levels and CEA tissue expression in patients with breast cancer is well known. Whereas immunohistochemistry shows positive CEA expression in 70-90%, the serum CEA levels are often within the normal range. We performed immunoscintigraphy and SPECT with a Tc-99m labelled anti-CEA monoclonal antibody (MAb BW 431/26) in 46 women with suspected breast cancer or recurrence. The results of anti-CEA immunoscintigraphy, mammography, serum CEA levels and immunohistochemistry were evaluated according to the histology of the tumor. Histology verified breast cancer or recurrence (pT1 [n = 7], pT2 [n = 17], pT3 [n = 3], pT4 [n = 3]) in 30 out of 46 patients; benign breast disease such as fibrocystic disease, fibroadenoma, fatty necrosis or chronic mastitis was responsible for suspicious mammographic findings in 16 patients. Immuno-SPECT showed 25 true-positive, 5 false-negative, 11 true-negative and 5 false-positive findings (sensitivity 83%, specificity 69%). Anti-CEA immuno-SPECT of 2 patients with bone metastasis showed all lesions previously detected by bone scintigraphy to be CEA-expressing metastases. In contrast, serum CEA levels were slightly elevated in only 5 out of 30 patients with histologically verified breast cancer (sensitivity 17%). The results of immuno-histochemistry were surprising; tissue CEA expression could be demonstrated in only 5 patients with breast cancer. According to our experiences with this Tc-99m labelled anti-CEA MAb, immuno-SPECT is a suitable additional method for the diagnosis of breast cancer and especially of recurrence. Pre-operative serum CEA levels give no support for the differentiation between benign and malignant breast tumors.     

Evaluation of a tumor-associated antigen CA 15-3 in the sera of patients with breast cancer

Serum levels of CA 15-3 were determined in normal women and patients with breast cancer and other diseases. The serum concentration of normal subjects was 9.8 +/- 4.4 units/ml (mean +/- S.D., n = 97). The patients with primary and recurrent breast cancer had significantly higher levels of CA 15-3, their values being 23.1 +/- 59.6 (n = 47) and 127.6 +/- 179.7 (n = 32) units/ml, respectively. When the value of 20 units/ml was used as the cutoff for the normal value, the positive rates were 4%, 26% and 75% in normal women and breast cancer patients primary and recurrent, respectively. No increased levels were found in the sera of patients with benign breast diseases or with gastrointestinal, thyroid, lung and other cancers. The elevated levels of CA 15-3 decreased after successful therapy both in primary and recurrent breast cancer patients, while there was no change in nonresponders. The measurement of serum CA 15-3 would be useful for monitoring the therapy and for detection of the recurrence of breast cancer.     

Activity of the enzymes of DNA metabolism in the blood of patients with breast cancer

Age-related changes in the activity of thymidine- and adenosine-metabolizing enzymes were studied in healthy females and those with breast cancer aged 46-70 years. A significant increase in activity of thymidine kinase, adenosine deaminase and 5'-nucleotidase and a decrease in that of thymidine phosphorylase were registered in blood serum of breast cancer patients of all age brackets. Adenosine deaminase activity in blood serum and lymphocytes of breast cancer patients was found to significantly change after surgery. A direct correlation was established between pretreatment thymidine phosphorylase activity and histological type of tumor, on the one hand and results of chemotherapy, on the other. The applicability of enzyme level assay for evaluating response to pre- and postoperative medication was studied.     

Vitamin D Receptor in Breast Cancer Tissues and Its Relation to Estrogen Receptor Alpha (ER-α) Gene Expression and Serum 25-hydroxyvitamin D Levels in Egyptian Breast Cancer Patients: A Case-control Study

IntroductionThis study aimed to explore the role of vitamin D receptor (VDR) in breast cancer tissues and its relation to serum 25-hydroxyvitamin D [25(OH)D] levels and estrogen receptor alpha (ER-α) gene expression in patients with breast cancer.Patients and MethodsCancerous and normal breast tissues from 40 women with breast cancer were analyzed for quantification of VDR levels and ER-α gene expression. The serum levels of 25(OH)D were measured in patients with breast cancer and controls by radioimmunoassay.ResultsPatients with breast cancer had serum levels of 25(OH)D significantly lower than normal control subjects. The levels of VDR and ER-α were significantly higher in breast cancer tissues than in normal breast tissues. The serum levels of 25(OH)D were indirectly and significantly correlated with the tissue levels of both VDR and ER-α gene expression. There was a significant direct correlation between the tissue levels of VDR and ER-α gene expression. The serum 25(OH) D levels, tissue VDR levels, and ER-α gene expression levels were inversely and significantly correlated with breast cancer histopathologic grade. Women with serum 25(OH)D levels ≤ 30 nmol/L, tissue levels of VDR > 5 ng/mL, and tissue levels of ER-α gene expression > 17.7 copies had significantly increased risk for breast cancer incidence.ConclusionWomen with low serum 25(OH)D levels, high tissue levels of VDR, and ER-α gene expression had increased risk for breast cancer. VDR are upregulated in breast cancer tissues thus it may be used for target therapy especially in hormone-negative breast cancer.     

Serum soluble interleukin 2 receptor levels in patients with breast cancer

Preoperative levels of serum soluble interleukin-2 receptor (1L-2R) were examined in 37 patients with breast cancer. We investigated the correlations of serum soluble IL-2R levels with various factors such as stage grouping, lymph node metastasis, distant metastasis, tumor size, histophthological type, estrogen receptor (ER), progesterone receptor (PgR) and CA 15-3. Serum soluble 1L-2R levels were measured with an enzyme-linked immunosorbent assay. Levels of serum soluble 1L-2R in the patients with stage III and IV breast cancer were significantly higher than those in the normal controls, and patients with stage I and II breast cancer. Preoperative levels of serum soluble IL-2R in patients with T3 and T4 were also significantly higher than those in patients with T1 and T2. Serum levels of IL-2R in patients with distant metastasis were also significantly higher than those in patients without distant metastasis. Moreover, serum levels of soluble IL-2R in patients with higher CA 15-3 were significantly higher than those in patients with normal CA 15-3 levels. We conclude that preoperative serum soluble IL-2R levels in patients with breast cancer may be a valuable parameter, especially in evaluating whether they have distant metastasis or not.     

血清肝细胞生长因子水平与乳腺癌转移的关系

目的:研究血清肝细胞生长因子(hepatocytegrowthfactory,HGF)与乳腺癌转移的关系。方法:应用双抗体夹心ELISA方法检测80例术后复发转移乳腺癌患者,50例术后无复发乳腺癌患者和20例献血员的血清肝细胞生长因子水平。结果:术后复发转移组血清HGF水平(0.90±0.52ng/ml)显著高于无复发组(0.38±0.30ng/ml;P<0.01)和正常对照组(0.22±0.36ng/ml;P<0.01)。肝转移组患者血清HGF水平(1.25±0.57ng/ml)显著高于其它转移组(0.78±0.48ng/ml;P<0.01)。多处转移组血清HGF水平(1.10±0.66ng/ml)显著高于其它转移组(0.78±0.48ng/ml;P<0.05)。结论:血清HGF水平与乳腺癌肝转移和多处转移发生密切相关。     

BSP TRACP5b与乳腺癌术后骨转移相关性研究初探

目的：回顾性研究BSP蛋白在原发性乳腺癌组织中的表达及乳腺癌患者术后血清TRACP5b水平,探讨二者与骨转移的关系,旨在探究早期预测乳腺癌术后骨转移的方法.方法：应用免疫组织化学S-P方法及酶联免疫吸附法（ELISA）测定35例原发性乳腺癌石蜡标本中BSP蛋白表达情况及患者术后血清TRACP5b水平.结果：应用Spearman等级相关分析显示,BSP蛋白表达与骨转移成正相关,相关系数r=0.439（P＜0.01）,而血清TRACP5b水平与骨转移尚不存在相关关系（P＞0.05）.结论：预测乳腺癌术后骨转移的方法不仅停留于传统的外周血检测,还可以早期进行组织水平的检测,同时可以进行两个水平的相关性研究.     

Thymidine kinase in breast cancer

The enzyme thymidine kinase is associated with DNA synthesis. Thymidine kinase serum levels were studied in normal controls (n = 20), patients with primary breast cancer (n = 60), patients with systemic breast cancer (n = 20) and as a non-cancer disease control group in patients with inflammatory gastrointestinal disorders (n = 20). Comparison of pretreatment values in the cancer patients with the normal controls showed a significant difference between the three groups in relation to stage of disease: mean values 4.22 (+/- 1.08), 6.22 (+/- 2.24) and 9.79 (+/- 7.56) pmol ml-1 h-1 for normal controls, operable breast cancer and systemic breast cancer respectively (P less than 0.005; analysis of variance). Patients with systemic breast cancer had a significantly elevated serum thymidine kinase level compared to controls (P less than 0.01) and patients with primary operable cancer (P less than 0.05). Patients with primary operable cancer had significantly higher serum thymidine kinase levels over normal controls (P less than 0.01). Mean serum TK in patients with inflammatory gastrointestinal diseases was similar to normal controls but significantly less than both patients with primary operable breast cancer and patients with systemic breast cancer. Twenty patients with operable breast cancer were followed up after primary surgery by serial 3-monthly thymidine kinase levels in the disease free interval. Four patients have developed systemic recurrence with a rise in the mean thymidine kinase value to 14.3 pmol ml-1 h-1. Ten patients with advanced breast cancer had serial thymidine kinase levels measured 2-monthly during the first 6 months of primary hormone therapy. The serum values fell in all five responders (mean 9.12-4.78 pmol ml-1 h-1) and rose in all five progressors (mean 8.62-38.5 pmol ml-1 h-1). Serum thymidine kinase reflects stage of disease in breast cancer. Serial thymidine kinase levels in patients with systemic breast cancer reflected response to systemic therapy.     

Relationships among serum CA15-3 tumor marker, TNM staging, and estrogen and progesterone receptor expression in benign and malignant breast lesions

Serum tumor marker CA15-3 is widely used in follow-up for assessment of breast cancer prognosis. The aim of this study was to evaluate levels among healthy females and patients, to assess differences with tumor stage and grade, and to determine the relationship with estrogen and progesterone receptor expression. One hundred and thirty six Jordanian females were enrolled in this study: Forty-five were healthy females; seventy-two were diagnosed with breast cancer and nineteen diagnosed with benign breast lesions. Elevated serum CA15-3 level was significantly observed among breast cancer patients (37.95±6.65) compared to both healthy (14.97±0.8) and benign females (12.30±1.55), but no significant association was detected between serum CA15-3 level and age of cancer onset, menarche age, menopause age, parity and BMI. Decreased CA15-3 level was significantly associated with hormone therapy and oral contraceptive consumption among breast cancer patients. Significantly elevated CA15-3 serum levels were found among grade II, III and stage II and III breast cancer females compared to normal healthy females. Elevated CA15-3 serum levels were also found among ER+/PR+ (54.242±7.89) and ER+/PR- (37.08±8.22) compared to healthy control females.     

TPS in breast cancer--a comparative study with carcinoembryonic antigen and CA 15-3.

The serum levels of tissue polypeptide antigen were determined using the M3 monoclonal antibody (TPS) and compared with the serum levels of carcinoembryonic antigen (CEA) and breast carcinoma antigen 15-3 (CA 15-3) in 96 patients with benign breast tumors, in 25 breast cancer patients with no evidence of disease, in 139 preoperative breast cancer patients and in 298 samples of 25 breast cancer patients during therapy monitoring (4-22 samples per patient). The 95th percentile of TPS in 89 apparently healthy females was 51 U/l. The 95th percentile of TPS in patients with benign breast tumors was 55 U/l. The maximum TPS level in breast cancer patients with no evidence of disease was 56 U/l. In preoperative breast cancer the number of patients with TPS levels above the 95th percentile of TPS in benign breast tumors was significantly higher in stage III breast cancer as compared with stage I+II. This was not established for CEA and CA 15-3. During therapy monitoring TPS followed the course of the disease faster than CEA and CA 15-3 in patients with bone metastases, liver metastases, lung metastases and pleural effusion, with one exception. TPS levels could be correlated with progression of disease in patients with normal and steady levels of CEA and/or CA 15-3.     

V i t D / V D R 与乳腺癌患者免疫状态、临床特征及预后的相关性研究

背景与目的：维生素D（vitamin D，VitD）是一种类固醇激素，外周血25羟基VitD［25-hydroxy VitD，25（OH）D］的血清浓度被认为是体内VitD状态的主要生物标志物，通过检测乳腺癌患者外周血清中25（OH）D的水平，探讨VitD与乳腺癌患者各项临床特征的相关性。方法：对比2015年1月—2018年7月上海交通大学附属第六人民医院收治的乳腺癌患者109例、乳腺良性肿瘤患者50例及健康体检者2 000例的外周血血清中25（OH）D的水平差异，并进一步检测乳腺癌患者的T细胞免疫功能、NK细胞水平，同时应用免疫组织化学方法检测乳腺癌患者癌组织中VitD受体（VitD receptor，VDR）的表达。结果：乳腺癌患者外周血中25（OH）D水平显著低于乳腺良性肿瘤患者和健康体检者，差异有统计学意义（P ＜0.05）。乳腺良性肿瘤患者与健康体检者外周血25（OH）D水平无明显差异（P＞0.05）。乳腺癌患者外周血25（OH）D水平与患者T细胞免疫功能（CD4⁺/CD8⁺比值）、临床分期、淋巴结是否受累、是否骨转移、孕激素受体（progesterone receptor，PR）是否阳性均有显著相关性（P＜0.05），而与肿瘤大小、NK细胞水平、雌激素受体（estrogen receptor，ER）是否阳性无显著相关性（P＞0.05）。乳腺癌组织VDR的表达与乳腺癌患者的T细胞免疫功能、临床分期、肿瘤大小、是否骨转移、是否淋巴结转移均无显著相关性（P＞0.05），而与ER、PR是否阳性具有显著相关性（P ＜0.05）。结论：外围血中VitD水平低可能与乳腺癌发病风险高、T细胞免疫功能低下及预后差有关。     

Clinical relevance of soluble c-erbB-2 for patients with metastatic breast cancer predicting the response to second-line hormone or chemotherapy.

Concentrations of soluble c-erbB-2 were determined in the sera of 64 patients with distant metastasis from advanced breast cancer receiving second-line hormone or chemotherapy in comparison to 35 breast cancer patients without detectable recurrent disease and 17 healthy blood donors. The sera of non-metastatic breast cancer patients contained s-erbB-2 concentrations similar to those of healthy blood donors. Patients with distant metastasis from advanced breast cancer had significantly higher values of s-erbB-2 in comparison to patients with non-disseminated disease (mean: 59.6 vs. 11.6 U/ml; p = 0.022). A significant correlation was observed between s-erbB-2 serum levels and serum LDH concentrations (p < 0.001), levels of alkaline phosphatase (p < 0.001), and the presence of hepatic metastasis (p = 0.001). Time to tumor progression was significantly shorter in patients with s-erbB-2 levels above 40 U/ml (mean: 23.4 vs. 56.7 months; p = 0.002). Furthermore, breast cancer patients with hepatic metastasis and those with elevated s-erbB-2 serum levels above 40 U/ml had limited response to hormone or chemotherapy. Non-responders had significantly higher s-erbB-2 levels (mean: 270.3, range: 42-500 U/ml;) compared with the responder group (mean: 23.1, range: 0-149 U/ml; p < 0.001). Logistic regression analysis indicated that elevated s-erbB-2 serum levels above 40 U/ml independently predicted an unfavorable response to second-line hormone or chemotherapy in patients with advanced metastatic breast cancer.     

Baseline serum NTx levels are prognostic in metastatic breast cancer patients with bone-only metastasis.

BACKGROUND: There is significant heterogeneity in survival of patients with metastatic breast cancer who have bone-only metastasis. We studied the correlation of serum N-telopeptide (NTx), a marker of bone resorption, and its correlation with clinical outcomes in patients with metastatic breast cancer with bone-only or bone plus soft tissue metastasis. PATIENTS AND METHODS: Serum was taken from 250 metastatic breast cancer patients with bone-only or bone plus soft tissue metastasis who participated in two similar randomized studies of second-line hormone therapy. An enzyme-linked immunosorbent assay specific for NTx of type I bone collagen was used to detect serum levels. RESULTS: Sixty patients (24%) had elevated serum NTx levels, using the mean + 2 standard deviations (26 nanomoles Bone Collagen Equivalents per liter) of healthy women as a cut-off. The median duration of clinical benefit was significantly shorter in the group with elevated serum NTx levels compared with the group that had normal serum NTx levels (P=0.0004). Time to progression (TTP) was also significantly shorter in the patients with elevated serum NTx at 139 days compared with 220 days (P=0.0006). Median survival was also significantly shorter in patients with elevated baseline serum NTx levels at 663 days compared with 941 days (P<0.0001). CONCLUSION: In this study, breast cancer patients with bone-only or bone plus soft tissue metastasis and elevated serum NTx levels have a shorter duration of clinical benefit, TTP and overall survival.     

血清抵抗素、脂联素和瘦素水平与乳腺癌的相关性研究

目的研究乳腺癌患者抵抗素、脂联素、瘦素及血脂变化及其临床意义。方法 90例经病理诊断为乳腺癌的患者为病例组,50例与之年龄匹配的健康人群为对照组,测定血清中的抵抗素,脂联素、瘦素、空腹血糖（FBG）及血脂。结果病例组脂联素及高密度脂蛋白胆固醇（HDL-C）显著降低（P〈0.01或P〈0.05）。病例组抵抗素、瘦素、空腹血糖及甘油三酯均明显增加（P〈0.01或P〈0.05）。但抵抗素、脂联素及瘦素在绝经前乳腺癌患者与健康对照组之间差异无统计学意义（P〉0.05）。有淋巴结转移的乳腺癌患者与无淋巴结转移乳腺癌患者间,抵抗素、脂联素及瘦素差异有统计学意义（P〈0.01）。逐步回归分析显示,脂联素及HDL的降低,瘦素和抵抗素的升高将会增加罹患乳腺癌的风险。血清中脂联素降低和瘦素的增加与乳腺癌患者淋巴结的转移呈现相关性。结论血清中脂联素水平的降低和抵抗素及瘦素水平的升高是乳腺癌患病的危险因素。血清较低的脂联素和较高的瘦素是乳腺癌转移的危险因素。     

Tartrate-resistant acid phosphatase 5b activity is a useful bone marker for monitoring bone metastases in breast cancer patients after treatment.

Metabolic markers of bone metabolism may be useful for the diagnosis and monitoring of bone metastasis in breast cancer patients. Serum tartrate-resistant acid phosphatase 5b (TRACP5b) activity is a novel bone resorption marker. The treatment response of serum TRACP5b activity, bone alkaline phosphatase (BAP) activity, and concentrations of NH(2)-terminal telopeptide of type 1 collagen (NTX) in 68 breast cancer patients with bone metastasis were determined. These patients were treated and followed up as clinically indicated. Fifty-four healthy women were recruited as control. Serum TRACP5b activity, BAP activity, and NTX level of breast cancer patients with bone metastasis were significantly higher than those of normal controls. In normal subjects, serum TRACP5b activity and NTX level are significantly correlated (P < 0.0001). Neither was correlated with BAP activity. In breast cancer patients with bone metastasis, all marker pairs correlated to each other significantly (P < 0.0001). Biomarkers were examined repeatedly in 38 patients who were evaluable for treatment response. Based on clinical criteria, 20 patients were responders and 18 were nonresponders. In the 20 responders, serum TRACP5b activity and NTX level decreased significantly (P < 0.0001 and 0.0107, respectively) after treatment. In the 18 nonresponders, only NTX level showed significant increase (P = 0.0342) after treatment; TRACP5b and BAP were unchanged. By means of multiple logistic regression with stepwise selection, we determined that TRACP5b activity has a higher probability than NTX level to indicate treatment response as a function of percent change after treatment (18 times versus 12 times). Our data support the use of either TRACP5b activity or NTX level to follow up breast cancer patients with bone metastasis after treatment instead of the prevailing BAP activity.