血清TSH、TSGF与p185蛋白联合诊断乳腺癌的临床意义

目的探讨血清促甲状腺激素(TSH)、肿瘤特异性生长因子(TSGF)水平、p185蛋白阳性率与乳腺癌疾病的相关性。方法选择2016年8月至2018年10月应城市人民医院收治的60例乳腺癌患者作为研究对象,按照TNM分期分为Ⅰ-Ⅱ组(Ⅰ-Ⅱ期患者)36例和Ⅲ-Ⅳ组(Ⅲ-Ⅳ期患者)24例,另选取我院同期健康体检人群60例作为对照组。对比分析3组患者血清TSH、TSGF水平及p185蛋白阳性率及不同病理特征下患者TSH、TSGF水平及p185蛋白阳性率之间的差异,分析联合检测和单独检测之间的差异。结果3组间TSH、TSGF水平及p185蛋白阳性率比较,差异有统计学意义(P<0.05)。与对照组相比,Ⅰ-Ⅱ组和Ⅲ-Ⅳ组患者血清中TSH、TSGF水平及p185蛋白阳性率更高,差异有统计学意义(P<0.05)。不同组织分级、TNM分期以及淋巴结转移情况的乳腺癌患者的TSH、TSGF水平及p185蛋白阳性率比较,差异有统计学意义(P<0.05);而不同肿瘤直径和分子分型的乳腺癌患者的TSH、TSGF水平及p185蛋白阳性率比较,差异无统计学意义(P>0.05)。Spearman相关性分析显示,组织分级、TNM分期、淋巴结转移、病理状态与乳腺癌患者的TSH、TSGF水平及p185蛋白阳性率呈显著相关性(P<0.05)。Logistic多因素分析结果显示,血清TSH(OR=1.019,P=0.001)、TSGF(OR=1.632,P=0.001)、p185蛋白阳性率(OR=1.089,P=0.000)是乳腺癌发生的独立危险因素。ROC诊断曲线结果显示,联合血清TSH、TSGF水平及p185蛋白阳性率的诊断效能显著高于单独指标的诊断效能(P<0.05)。结论乳腺癌患者的血清TSH、TSGF水平及p185蛋白阳性率与病理分期显著相关,且联合检测诊断效能更高,可作为诊断的依据。

Clinical significance of TSH,TSGF combined with p185 protein in diagnosis of breast cancer

Objective To study the correlation between the expression of thyroid stimulating hormone(TSH),tumor supplied group of factors(TSGF),p185 protein and breast cancer.Methods Totally 60 patients with breast cancer in Yingcheng people′s hospital from August 2016 to October 2018 were selected and divided intoⅠ-Ⅱgroup(36 patients withⅠ-Ⅱstage)andⅢ-Ⅳgroup(24 patients withⅢ-Ⅳstage)according to TNM stages,another 60 healthy people were selected as the control group.The levels of serum TSH,TSGF and the positive expression rate of p185 in three groups were compared and analyzed,the differences among the levels of serum TSH,TSGF and the positive expression rate of p185 in patients with different pathological characteristics were analyzed.Differences between individual tests and combined test were observed.Results There was no significant difference in the levels of serum TSH,TSGF and the positive expression rate of p185 among three groups(P<0.05).Compared with the control group,the levels of serum TSH,TSGF and the positive expression rate of p185 in other two groups,the differences were significant(P<0.05).There were significant differences in the levels of serum TSH,TSGF and the positive expression rate of p185 of patients with different tissue grade,TNM stage and lymph node metastasis(P<0.05),but there was no significant difference in the levels of serum TSH,TSGF and the positive expression rate of p185 of patients with different tumor diameter and molecular typing.Spearman correlation analysis showed that tissue grade,TNM stage,lymph node metastasis,and pathological state were significantly correlated to the levels of serum TSH,TSGF and the positive expression rate of p185(P<0.05).Logistic multivariate analysis showed that serum TSH(OR=1.019,P=0.001),TSGF(OR=1.632,P=0.001)and positive expression rate of p185(OR=1.089,P=0.000)were independent risk factors for breast cancer occurrence(P<0.05).The results of ROC diagnostic curve showed that the diagnostic efficacy of combined serum levels of TSH,TSGF and positive expression rate of p185 was significantly higher than that of individual index(P<0.05).Conclusion The serum TSH,TSGF and p185 protein levels of breast cancer patients are significantly correlated with pathological stage,which can be used as the basis for diagnosis.The diagnostic efficacy of combined test is higher than individual test.