Chen Z, Xu S, Su D, Liu W, Yang H, Xie S, Meng X, Lei L, Wang X
Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310022, China.
Clin Transl Oncol. 2015 Jun;17(6):486-94. doi: 10.1007/s12094-014-1264-9. Epub 2014 Dec 16.
To explore the association between the 3,144 m/z protein peak and the clinicopathological features and prognosis in breast cancer.
Using SELDI-TOF MS, we analyzed serum protein peak at 3,144 m/z in 283 patients with node-positive breast cancer, its relationship with clinicopathological features and their prognosis evaluating value of survival.
3,144 m/z positive rate was higher in elderly patients (42.8 % in ≥50-year-old vs. 31.2 % in <50, P = 0.04). However, no correlation was observed between 3,144 m/z and other clinicopathological features (body mass index, menstrual status, family history, TNM, molecular subtypes, vascular invasion, neural invasion, p53 and CA15-3). However, the positive rate of 3,144 m/z was higher than that of CA15-3 (35.5 vs. 11.4 %, McNemar χ (2) test, p < 0.001). 3,144 m/z-negative patients (n = 177) had a better 3-year overall survival (OS) than 3,144 m/z-positive patients (n = 106) (89.8 vs. 81.2 %, P = 0.045). Younger patients (P = 0.016), postmenopausal status (P = 0.019), small tumor (P < 0.001), less positive nodes (P < 0.001), early stage (P < 0.001), favorable molecular subtype (P = 0.007), normal CA15-3 (P = 0.003) and neoadjuvant chemotherapy (P = 0.001) predicted better survival. Cox analysis showed that T3-4 (95 % CI 1.419-8.057, P = 0.006), lymph node metastasis (95 % CI 1.242-3.632, P = 0.006) and p53 mutation (95 % CI 1.088-6.378, P = 0.032) were independent adverse prognostic factors. But childbirth ≥2 (95 % CI 0.163-0.986, P = 0.046), adjuvant chemotherapy (95 % CI 0.062-0.921, P = 0.038) and adjuvant radiotherapy (95 % CI 0.148-0.928, P = 0.034) were the independent factors in reducing risk of death in breast cancer patients. Combination testing of 3,144 m/z and CA15-3 will improve the prognosis value of 3-year survival (P = 0.011); patients with CA153-/3144- were characterized by the longest survival (89.8 %) and the CA153+/3144+ patients by the shortest.
Serum protein peak at 3,144 m/z is a new biomarker for breast cancer diagnosis and prognosis and showed a higher positive rate than serum CA15-3. Combining 3,144 m/z and CA15-3 testing may improve prognosis of longer survival in breast cancer patients.
探讨3144 m/z蛋白峰与乳腺癌临床病理特征及预后之间的关联。
采用表面增强激光解吸电离飞行时间质谱（SELDI-TOF MS）分析283例淋巴结阳性乳腺癌患者血清中3144 m/z的蛋白峰，分析其与临床病理特征的关系及其对生存的预后评估价值。
老年患者中3144 m/z阳性率较高（≥50岁患者中为42.8%，<50岁患者中为31.2%，P = 0.04）。然而，未观察到3144 m/z与其他临床病理特征（体重指数、月经状态、家族史、TNM、分子亚型、血管侵犯、神经侵犯、p53和CA15-3）之间存在相关性。然而，3144 m/z的阳性率高于CA15-3（35.5%对11.4%，McNemar χ²检验，p < 0.001）。3144 m/z阴性患者（n = 177）的3年总生存率（OS）优于3144 m/z阳性患者（n = 106）（89.8%对81.2%，P = 0.045）。年轻患者（P = 0.016）、绝经后状态（P = 0.019）、肿瘤较小（P < 0.001）、阳性淋巴结较少（P < 0.001）、早期（P < 0.001）、有利的分子亚型（P = 0.007）、CA15-3正常（P = 0.003）和新辅助化疗（P = 0.001）预示着更好的生存。Cox分析显示，T3-4（95%CI 1.419 - 8.057，P = 0.006）、淋巴结转移（95%CI 1.242 - 3.632，P = 0.006）和p53突变（95%CI 1.088 - 6.378，P = 0.032）是独立的不良预后因素。但分娩≥2次（95%CI 0.163 - 0.986，P = 0.046）、辅助化疗（95%CI 0.062 - 0.921，P = 0.038）和辅助放疗（95%CI 0.148 - 0.928，P = 0.034）是降低乳腺癌患者死亡风险的独立因素。联合检测3144 m/z和CA15-3可提高3年生存的预后价值（P = 0.011）；CA153-/3144-的患者生存期最长（89.8%），而CA153+/3144+的患者生存期最短。
血清中3144 m/z的蛋白峰是乳腺癌诊断和预后的一种新生物标志物，其阳性率高于血清CA15-3。联合检测3144 m/z和CA15-3可能改善乳腺癌患者更长生存期的预后。
