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浸润性导管癌眼部转移的危险因素及其诊断价值。

Risk factors and their diagnostic values for ocular metastases in invasive ductal carcinoma.

机构信息

Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

Department of Ophthalmology, Xiang'an Hospital of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen University, Xiamen University School of Medicine, Xiamen, Fujian Province, China.

出版信息

Cancer Med. 2021 Feb;10(3):824-832. doi: 10.1002/cam4.3656. Epub 2020 Dec 18.

Abstract

Invasive ductal carcinoma (IDC) is a major type of breast cancer. Ocular metastasis (OM) in IDC is rarely seen, but patients with OM often have a poor prognosis. Furthermore, OM is difficult to detect in the early stages by common imaging examinations. In the present study, we tried to figure out the risk factors of OM in IDC and evaluate their diagnostic values for early detection. There were 1192 IDC patients who were divided into two groups according to ocular metastasis involved in this study. Clinical parameters of those patients were used to detect differences. The binary logistic regression test was then used to determine the risk factors of OM in IDC. Furthermore, ROC curves of both single and combined risk factors were established to examine their diagnostic values. The incidence of axillary lymph node metastases was significantly higher in the OM group (p = 0.002). Higher carbohydrate antigen 153 (CA153), lower apolipoprotein A1 (ApoA1), and hemoglobin (Hb) were risk factors for OM in IDC (p < 0.001, p < 0.001, p = 0.038, respectively). In the single risk factor ROC analysis, cutoff values of CA153, ApoA1, and Hb were 43.3 u/mL (CI: 0.966-0.984, p < 0.001), 1.11 g/L (CI: 0.923-0.951, p < 0.001), and 112 g/L (CI: 0.815-0.857, p < 0.001), respectively. Among the ROC curves of combined risk factors, CA153+ApoA1+Hb had the best accuracy, with the sensitivity and specificity of 89.47% and 99.32%, respectively (CI: 0.964-0.983, p < 0.001). CA153, ApoA1, and Hb are risk factors for OM in IDC. In clinical practice, the three parameters could be used as predictive factors for the early detection of OM.

摘要

浸润性导管癌(IDC)是乳腺癌的主要类型。IDC 眼转移(OM)很少见,但 OM 患者的预后通常较差。此外,OM 通常难以通过常见的影像学检查在早期发现。在本研究中,我们试图找出 IDC 中 OM 的危险因素,并评估其早期检测的诊断价值。根据本研究中是否存在眼部转移,将 1192 例 IDC 患者分为两组。使用这些患者的临床参数来检测差异。然后使用二项逻辑回归检验确定 IDC 中 OM 的危险因素。此外,还建立了单因素和多因素的 ROC 曲线,以检验其诊断价值。OM 组腋窝淋巴结转移的发生率明显较高(p=0.002)。较高的糖链抗原 153(CA153)、较低的载脂蛋白 A1(ApoA1)和血红蛋白(Hb)是 IDC 中 OM 的危险因素(p<0.001,p<0.001,p=0.038)。在单因素 ROC 分析中,CA153、ApoA1 和 Hb 的截断值分别为 43.3 u/mL(CI:0.966-0.984,p<0.001)、1.11 g/L(CI:0.923-0.951,p<0.001)和 112 g/L(CI:0.815-0.857,p<0.001)。在多因素风险因素的 ROC 曲线中,CA153+ApoA1+Hb 具有最佳准确性,其敏感性和特异性分别为 89.47%和 99.32%(CI:0.964-0.983,p<0.001)。CA153、ApoA1 和 Hb 是 IDC 中 OM 的危险因素。在临床实践中,这三个参数可作为 OM 早期检测的预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10d8/7897965/f567f36747a8/CAM4-10-824-g001.jpg

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