引用本文:张 腾,张 超,李 智,于 满,任欣玲,田梓儒,史立晖.循环肿瘤细胞联合血清整合素β1对病理性乳头溢液患者乳管内恶性病变的诊断价值[J].中国临床新医学,2024,17(5):543-547.
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循环肿瘤细胞联合血清整合素β1对病理性乳头溢液患者乳管内恶性病变的诊断价值
张 腾1,张 超2,李 智1,于 满3,任欣玲3,田梓儒3,史立晖1
1.北京市通州区妇幼保健院乳腺科,北京 101100;2.首都医科大学附属北京朝阳医院乳腺外科,北京 100000;3.首都医科大学教育处,北京 100000
摘要:
[摘要] 目的 探讨循环肿瘤细胞(CTCs)联合整合素β1(ITG β1)对病理性乳头溢液(PND)患者乳管内恶性病变的诊断价值。方法 回顾性分析2022年1月至2023年9月北京市通州区妇幼保健院及首都医科大学附属北京朝阳医院收治的212例PND患者的临床资料,根据乳管病理检查结果将研究对象分为良性病变组(187例)和恶性病变组(25例)。采用差异富集-荧光免疫染色原位杂交技术(SE-iFISH)检测PND患者CTCs数量,采用酶联免疫吸附试验检测PND患者血清ITG β1水平。采用多因素logistic回归分析PND患者发生乳管内恶性病变的影响因素。通过受试者工作特征(ROC)曲线分析CTCs数量、血清ITG β1水平对PND患者乳管内恶性病变的诊断效能。结果 两组年龄、体质量指数(BMI)、月经状态、溢液类型、乳腺肿块比较差异有统计学意义(P<0.05)。恶性病变组CTCs数量多于良性病变组,血清ITG β1水平高于良性病变组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,年龄>50岁、BMI>24 kg/m2、血样溢液、较多的CTCs数量、较高的血清ITG β1水平是PND患者发生乳管内恶性病变的独立危险因素(P<0.05)。CTCs数量、血清ITG β1水平均具有诊断PND患者乳管内恶性病变的应用价值(P<0.05),且两项指标联合检测的诊断效能更优[AUC(95%CI)=0.961(0.925~0.983),P<0.001],灵敏度和特异度分别为96.00%、84.49%。结论 CTCs数量、血清ITG β1水平在乳管内恶性病变的PND患者体内显著升高,二者联合对PND患者乳管内恶性病变具有较好的诊断价值。
关键词:  病理性乳头溢液  乳管内恶性病变  循环肿瘤细胞  整合素β1  诊断价值
DOI:10.3969/j.issn.1674-3806.2024.05.12
分类号:R 737.9
基金项目:北京市通州区科技计划项目(编号:KJ2020CX011)
The value of circulating tumor cells combined with serum integrin β1 in diagnosis of intraductal malignant lesions of mammary glands in patients with pathological nipple discharge
ZHANG Teng1, ZHANG Chao2, LI Zhi1, YU Man3, REN Xinling3, TIAN Ziru3, SHI Lihui1
1.Department of Breast, Beijing Tongzhou Maternal and Child Health Hospital, Beijing 101100, China; 2.Department of Breast Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100000, China; 3. Department of Education, Capital Medical University, Beijing 100000, China
Abstract:
[Abstract] Objective To explore the diagnostic value of circulating tumor cells(CTCs) combined with integrin β1(ITG β1) in pathological nipple discharge(PND) patients with intraductal malignant lesions of mammary glands. Methods The clinical data of 212 patients with PND who were admitted to Beijing Tongzhou Maternal and Child Health Hospital and Beijing Chaoyang Hospital, Capital Medical University from January 2022 to September 2023 were retrospectively analyzed. The research subjects were divided into benign lesion group(187 cases) and malignant lesion group(25 cases) according to the results of pathological examination of mammary ducts. The number of CTCs in the PND patients was detected by using subtraction enrichment and immunostaining-fluorescence in situ hybridization(SE-iFISH), and the serum ITG β1 level was detected by using enzyme-linked immunosorbent assay(ELISA). Multivariate logistic regression was used to analyze the influencing factors of intraductal malignant lesions of mammary glands in the PND patients. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of the number of CTCs and serum ITG β1 level on intraductal malignant lesions of mammary glands in the PND patients. Results There were significant differences in age, body mass index(BMI), menstrual status, type of discharge and breast mass between the two groups(P<0.05). The number of CTCs in the malignant lesion group was larger than that in the benign lesion group, and the serum ITG β1 level in the malignant lesion group was higher than that in the benign lesion group, and the differences were statistically significant(P<0.05). The results of multivariate logistic regression analysis showed that age more than 50 years, BMI more than 24 kg/m2, blood discharge, more CTCs and higher serum ITG β1 level were independent risk factors for developing intraductal malignant lesions of mammary glands in the PND patients(P<0.05). Both the number of CTCs and the serum ITG β1 level had the application value in the diagnosis of intraductal malignant lesions of mammary glands in the PND patients(P<0.05), and the combined detection of the two indicators had better diagnostic efficacy[AUC(95%CI)=0.961(0.925-0.983), P<0.001], and the sensitivity and specificity were 96.00% and 84.49%, respectively. Conclusion The number of CTCs and serum ITG β1 level are significantly elevated in PND patients with intraductal malignant lesions of mammary glands. The number of CTCs combined with serum ITG β1 level has better diagnostic value for intraductal malignant lesions of mammary glands in the PND patients.
Key words:  Pathological nipple discharge(PND)  Intraductal malignant lesions of mammary glands  Circulating tumor cells(CTCs)  Integrin β1(ITG β1)  Diagnostic value