Keskikuru Riitta, Bloigu Risto, Risteli Juha, Kataja Vesa, Jukkola Arja
Department of Oncology, Kuopio University Hospital, Kuopio, Finland.
Oncol Rep. 2002 Nov-Dec;9(6):1323-7.
The aim of this study was to evaluate the prognostic value of preoperative concentrations of the serum markers of type I collagen synthesis (PINP, PICP) and degradation (ICTP) in breast cancer. One hundred and eighty-four breast cancer patients without advanced disease were enrolled. Preoperative serum markers of type I collagen were assessed with specific radioimmunoassays. Elevated preoperative serum concentrations of ICTP (>4.9 microg/l) correlated statistically significantly with a poor prognosis for the breast cancer (P=0.0004) and shorter disease-free survival (P=0.02), and multivariate regression analysis likewise showed an elevated ICTP concentration (P=0.008), high grade (P=0.03) and high pathological stage (P=0.02) to be risk factors for poor survival. Sixty-five out of the 184 patients developed metastatic disease during the follow-up. The median follow-up time was 62 months (range 6-111 months). High ICTP (P=0.02) and large numbers of metastatic nodules (P=0.002) were prognostic factors for shorter disease-free survival in multivariate regression analysis. PINP and PICP had no significant prognostic value with respect to either overall or disease-free survival in this analysis. Our results indicate that preoperatively elevated serum ICTP is a prognostic factor in breast cancer, the measurement of which should improve the accuracy of predictions of the clinical outcome.
本研究旨在评估乳腺癌患者术前血清I型胶原蛋白合成标志物（PINP、PICP）及降解标志物（ICTP）浓度的预后价值。纳入184例无晚期疾病的乳腺癌患者。采用特异性放射免疫分析法评估术前血清I型胶原蛋白标志物。术前血清ICTP浓度升高（>4.9μg/l）与乳腺癌预后不良（P=0.0004）及无病生存期缩短（P=0.02）具有显著统计学相关性，多因素回归分析同样显示，ICTP浓度升高（P=0.008）、高级别（P=0.03）及高病理分期（P=0.02）是生存不良的危险因素。184例患者中有65例在随访期间发生转移。中位随访时间为62个月（范围6 - 111个月）。多因素回归分析显示，高ICTP（P=0.02）及大量转移结节（P=0.002）是无病生存期缩短的预后因素。在此分析中，PINP和PICP对总生存期或无病生存期均无显著预后价值。我们的结果表明，术前血清ICTP升高是乳腺癌的一个预后因素，检测该指标应能提高临床结局预测的准确性。
