帅晋豪,王鹏,季昳驰
SHUAI Jinhao,WANG Peng,JI Yichi

• 1:眉山市人民医院甲状腺乳腺外科

摘要(Abstract)：

目的 检测血清丝氨酸蛋白酶抑制剂A3(SERPINA3)在三阴性乳腺癌(TNBC)患者癌组织和癌旁组织中的表达水平，分析其对乳腺癌病理参数及预后的影响。方法 收集86例TNBC患者的肿瘤组织和癌旁组织标本，采用免疫组织化学检测组织中SERPINA3表达水平;根据免疫组化评分分为SERPINA3高表达组(免疫组化评分> 6分，n=51)和SERPINA3低表达组(免疫组化评分≤6分，n=35)，比较两组患者一般资料[年龄、体质量指数(BMI)、绝经、空腹血糖、甘油三酯、谷草转氨酶、谷丙转氨酶、血肌酐]和病理资料(肿瘤组织学分级、组织病理学分类、术后肿瘤局部复发、肿瘤直径、区域淋巴结状态、远处脏器转移);采用Kaplan-Meier分析法绘制两组患者的生存曲线图，Log-rank检验比较两组的生存率; Cox单因素和多因素回归分析影响TNBC患者无进展生存期和总生存期的危险因素。结果 SERPINA3在TNBC癌组织中的阳性表达率高于癌旁组织，差异有统计学意义(P <0.05);两组TNBC患者的肿瘤组织学分级、术后肿瘤局部复发、肿瘤直径、区域淋巴结阳性及远处脏器转移情况比较，差异有统计学意义(P <0.05); SERPINA3高表达组TNBC患者术后3年生存率低于低表达组，SERPINA3高表达组TNBC患者术后3年无进展生存率低于SERPINA3低表达组，差异有统计学意义(P <0.05); COX回归模型中分析显示肿瘤组织学分级Ⅲ级、术后肿瘤局部复发、肿瘤直径> 5 cm、区域淋巴结转移、远处脏器转移及SERPINA3高表达是影响TNBC患者总生存期的危险因素，术后肿瘤局部复发、区域淋巴结转移、远处脏器转移和SERPINA3高表达是影响患者无进展生存期的危险因素。结论 TNBC组织中SERPINA3高表达与TNBC恶性进展有关，影响患者的总生存率及无进展生存率。
Objective To investigate expression level of serine protease inhibitor A3( SERPINA3)in cancer tissues and para-cancer tissues of patients with triple-negative breast cancer( TNBC),and to analyze its effects on pathological parameters and prognosis of breast cancer. Methods The tumor tissues and para-cancer tissues of 86 TNBC patients were collected. The expression of SERPINA3 in the tissues was detected by immunohistochemistry. According to the immunohistochemistry score,samples were divided into SERPINA3 high expression group( immunohistochemical score≥6 points,n = 51) and SERPINA3 low expression group( immunohistochemical score ≤ 6 points,n = 35).General data( age,BMI,menopause,fasting blood glucose,triglyceride,aspartate aminotransferase,alanine aminotransferase,and serum creatinine) and pathological data( tumor histological grading,histo-pathological classification,post-operative local tumor recurrence,tumor diameter,local lymph node status,and distant organ metastasis) were compared between both groups. Survival curves of both groups were plotted by Kaplan-Meier analysis,and the Log-rank test was used to compare the survival rates between the two. Cox-univariate and multivariate regression analysis was adopted to investigate risk factors affecting progression-free survival and overall survival in TNBC patients. Results The positive expression rate of SERPINA3 in TNBC cancer tissues was higher than that in para-cancer tissues,differences were statistically significant( P < 0. 05). There were statistically significant differences in tumor histological grading, postoperative local tumor recurrence, tumor diameter,positive regional lymph nodes and distant organ metastasis between the two groups( P < 0. 05). The 3-year postoperative survival rate of TNBC patients in SERPINA3 high expression group was lower than that of low expression group,and the 3-year progression-free survival rate of TNBC patients in high expression group was lower than that of SERPINA3 low expression group, the difference was statistically significant( P < 0. 05). COX regression model analysis showed that tumor histological grading Ⅲ,postoperative tumor local recurrence,tumor diameter > 5 cm,regional lymph node metastasis,distant organ metastasis,and SERPINA3 high expression were risk factors affecting overall survival of TNBC patients. Postoperative tumor local recurrence,regional lymph node metastasis,distant organ metastasis,and SERPINA3 high expression were risk factors for progression-free survival of patients. Conclusion High expression of SERPINA3 in TNBC tissue is associated with malignant progression of TNBC,and affected the overall survival rate and progression-free survival rate of patients.

关键词(KeyWords)： 乳腺肿瘤;血清丝氨酸蛋白酶抑制剂A3;病理参数;总生存率;无进展生存率
breast cancer;serum serpin A3(SERPINA3);pathological parameters;overall survival rate;progression-free survival rate

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生计生委科研课题(16PJ175)

作者(Author): 帅晋豪,王鹏,季昳驰
SHUAI Jinhao,WANG Peng,JI Yichi

DOI: 10.19367/j.cnki.2096-8388.2023.02.006

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