乳腺癌患者血清中hMAM和CD147水平检测及其临床意义

目的：探讨乳腺癌患者血清中人乳腺珠蛋白（hMAM）和基质金属蛋白酶诱惑因子（CD147）水平及阳性表达率，阐明其在乳腺癌诊断中的临床意义。方法：选择122例乳腺癌患者（乳腺癌组）、21例乳腺纤维腺瘤患者（乳腺纤维腺瘤组）和16名健康对照者（健康对照组）作为研究对象。收集各组研究对象的血清，采用ELISA法检测各组研究对象血清中hMAM和CD147水平及阳性表达率，分析不同临床病理特征患者血清hMAM和CD147水平及阳性表达率。采用受试者工作特征（ROC）曲线确定乳腺癌患者血清中hMAM和CD147的cut-off值，确定其诊断乳腺癌的敏感度和特异度。结果：乳腺癌组患者血清中hMAM和CD147水平均高于健康对照组和乳腺纤维腺瘤组（P<0.05）。乳腺癌组患者血清中hMAM和CD147阳性表达率均高于健康对照组和乳腺纤维腺瘤组（P<0.01）；乳腺癌组患者血清中hMAM联合CD147的阳性表达率高于健康对照组和乳腺纤维腺瘤组（P<0.01）。是否有淋巴结转移乳腺癌患者血清中hMAM和CD147阳性表达率比较差异有统计学意义（χ²=10.375，P<0.01；χ²=15.556，P<0.01）。不同TNM分期、雌激素受体（ER）和人表皮生长因子受体2（Her-2）乳腺癌患者血清中CD147阳性表达率比较差异有统计学意义（χ²=8157，P<0.05；χ²=6.035，P<0.05；χ²=5.385，P<0.05）。随着TNM分期增加，乳腺癌患者血清中hMAM和CD147阳性表达率均呈递增趋势。hMAM的ROC曲线下面积（AUC）为0.809，95% CI：0.703~0.916；CD147的AUC为0.721，95% CI：0.582~0.861。hMAM的cut-off值为6.51 μg·L^-1，诊断乳腺癌的敏感度和特异度分别为61.1%和87.5%；CD147的cut-off值为144.92 ng·L^-1，诊断乳腺癌的敏感度和特异度分别为73.6%和68.7%；二者联合检测时AUC为0.880，95% CI：0.798~0.962，诊断乳腺癌敏感度和特异度分别为80.6%和81.2%。结论：血清中hMAM水平诊断乳腺癌具有较高的敏感度和特异度，hMAM与CD147联合检测可以提高诊断阳性率。

Detection of serum hMAM and CD147 levels of patients with breast cancer and its clinical significance

Objective: To explore the serum levels and the positive expression rates of human mammaglobin(hMAM) and extracellular matrix metalloproteinase inducer(CD147) of the patients with breast cancer,and to clarify their clinical significnaces in the diagnosis of breast cancer.Methods: A total of 122 patients with breast cancer(breast cancer group), 21 patients with breast fibroadenoma (breast fibroadenoma group)and 16 healthy controls (healthy control group)were selected as the subjects. The serum samples of subjects in various groups were collected.The serum levels and the positive expression rates of hMAM and CD147 of the subjects in various groups were measured by ELISA method. The serum levels and the positive expression rates of hMAM and CD147 of the breast cancer patients with different clinicopathological features were analyzed.The cut-off values of serum levels of hMAM and CD147 of the patients with breast cancer and their sensitivities and specificities in the dignosis of breast cancer were comfirmed by receiver operating characteristic (ROC) curve.Results: The serum levels of hMAM and CD147 of the patients in breast cancer group were higher than those in healthy control group and breast fibroadenoma group(P<0.05). The positive expression rates of hMAM and CD147 of the patients in breast cancer group were higher than those in healthy control group and breast fibroadenoma group(P<0.01); while the positive expression rates of serum hMAM combined with CD147 of the patients in breast cancer group were higher than those in healthy control group and breast fibroadenoma group(P<0.01).There were significant differences in the positive expression rates of serum hMAM and CD147 of breast cancer patients with lymph node metastasis or not (χ²=10.375,P<0.01; χ²=15.556, P<0.01). There were significant differences in the positive expression rates of serum CD147 of the breast cancer patients with different TNM stages, ER and Her-2 (χ²=8157, P<0.05;χ²=6.035,P<0.05; χ²=5.385,P<0.05).With the increasing of TNM stages, the positive expression rates of serum hMAM and CD147 were increased.The area under ROC curve(AUC) of serum level of hMAM was 0.809, 95%CI:0.703-0.916;the AUC of serum level of CD147 was 0.721, 95% CI:0.582-0.861. When the cut-off value of hMAM was 6.51 μg·L^-1,its sensitivity and specificity were 61.1% and 87.5%, respectively. The sensitivity and specificity were 73.6% and 68.7% respectively when the cut-off value of CD147 was 144.92 ng·L^-1. The AUC of detection of hMAM combined with CD147 was 0.880, 95% CI:0.798-0.962; the sensitivity and specificity were 80.6% and 81.2%, respectively.Conclusion: The serum level of hMAM has the high sensitivity and specificity in the diagnosis of breast cancer. Combined detection of hMAM and CD147 can improve the positive rate of diagnosis.