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血清脂肪因子:瘦素、抵抗素和内脂素在绝经后乳腺癌中的诊断及预测价值评估

Evaluation of diagnostic and predictive value of serum adipokines: Leptin, resistin and visfatin in postmenopausal breast cancer.

作者信息

Assiri Adel M A, Kamel Hala F M

机构信息

Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.

Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Medical Biochemistry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

Obes Res Clin Pract. 2016 Jul-Aug;10(4):442-53. doi: 10.1016/j.orcp.2015.08.017. Epub 2015 Sep 18.

Abstract

Obesity is a well-known risk factor for cancer. The associations of obesity with postmenopausal breast cancer (PBC) have been previously proven in clinical studies. The mechanisms underlying these associations remain unexplained completely, however, adipose tissue as an endocrine organ producing adipokines may interfere with cancer development. The aim of this study is to investigate the diagnostic and predictive value of serum levels of leptin, resistin and visfatin with inflammatory and tumour markers in relation to anthropometrics, clinicopathological features of PBC. This study included 298 postmenopausal Saudi females categorised into three groups. One hundred and ten BC patients with age matched, 89 healthy control (HC) and 99 females with benign breast lesion (BBL). For all subjects CA15-3, hsCRP, resistin, visfatin and leptin were measured by ELISA. Serum levels of leptin, resistin and visfatin were significantly higher in BC compared to BBL and HC groups (p<0.05). Their levels were also significantly higher in advanced TNM stage, tumour size, LN invasion, histological grade and negative ER or PR cases. The most significant predictor of leptin level was ER (p<0.05). While for resistin and visfatin level the most significant independent predictor was LN invasion. ROC analysis for serum leptin revealed AUC=0.795; 95% CI, 0.724-0.866. Resistin showed AUC=0.875; 95% CI, 0.821-0.928. Meanwhile, visfatin greater than 12.2ng/mL demonstrated a sensitivity and specificity of 97.6% and 92.6%, respectively and AUC=0.724; 95% CI, 0.643-0.804. In conclusion serum leptin, resistin, and visfatin levels could be considered of potential diagnostic value for PBC and they would be independent predictors of LN invasion and ER negative PBC cases.

摘要

肥胖是一种众所周知的癌症风险因素。肥胖与绝经后乳腺癌(PBC)之间的关联此前已在临床研究中得到证实。然而,这些关联背后的机制仍未完全阐明,脂肪组织作为产生脂肪因子的内分泌器官,可能会干扰癌症的发展。本研究的目的是探讨血清瘦素、抵抗素和内脂素水平与炎症及肿瘤标志物相关联时,相对于人体测量学、PBC临床病理特征的诊断和预测价值。本研究纳入了298名沙特绝经后女性,分为三组。110名年龄匹配的乳腺癌患者、89名健康对照(HC)和99名患有乳腺良性病变(BBL)的女性。对所有受试者采用酶联免疫吸附测定法(ELISA)检测CA15 - 3、超敏C反应蛋白(hsCRP)、抵抗素、内脂素和瘦素。与BBL组和HC组相比,乳腺癌组血清瘦素、抵抗素和内脂素水平显著更高(p<0.05)。在TNM晚期、肿瘤大小、淋巴结浸润、组织学分级以及雌激素受体(ER)或孕激素受体(PR)阴性的病例中,它们的水平也显著更高。瘦素水平最显著的预测因素是ER(p<0.05)。而对于抵抗素和内脂素水平,最显著的独立预测因素是淋巴结浸润。血清瘦素的ROC分析显示曲线下面积(AUC)=0.795;95%置信区间(CI)为0.724 - 0.866。抵抗素显示AUC = 0.875;95% CI为0.821 - 0.928。同时,内脂素大于12.2ng/mL时,敏感性和特异性分别为97.6%和92.6%,AUC = 0.724;95% CI为0.643 - 0.804。总之,血清瘦素、抵抗素和内脂素水平可被认为对PBC具有潜在诊断价值,并且它们将是淋巴结浸润和ER阴性PBC病例的独立预测因素。

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