Liu Z H, Yan W, Li F X, Li S X, Liu J T
Department of Prevention, Tianjin Medical University Cancer Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
Zhonghua Zhong Liu Za Zhi. 2022 Jun 23;44(6):562-569. doi: 10.3760/cma.j.cn112152-20200709-00633.
To investigate the correlation of homocysteine (HCY) and coagulation function index with the risk of breast cancer and its clinicopathological characteristics. The HCY, coagulation function test index, and clinicopathological information of female breast cancer patients (333 cases) treated in Tianjin Medical University Cancer Hospital from January 2018 to December 2018 were collected, and female patients with benign breast (225 cases) were selected during the same period for the control group. The t-test was used to compare measurement data with normal distribution, D-Dimer data were distributed discreetly and described by median, non-parametric Mann-Whitney U test was used to compare the two groups. The chi-square test was used to compare enumeration data, and the Logistic regression analysis was used for the risk analysis. The levels of HCY, fibrinogen (Fbg), protein C (PC), and median D-Dimer (D-D) in peripheral blood of breast cancer patients group [(13.26±5.24) μmol/L, (2.61±0.83) g/L, (117.55±19.67)%, and 269.68 ng/ml, respectively] were higher than those in the control group [(11.58±0.69) μmol/L, (2.49±0.49) g/L, (113.42±19.82)% and 246.98 ng/ml, respectively, <0.05]. The prothrombin time (PT), PT(INR), α2-antiplasmin (α2-AP) levels [(10.19±0.63) s, 0.91±0.07 and (110.64±13.93)%, respectively] were lower than those in the control group [(10.58±0.65) s, 0.93±0.01 and (123.81±14.77) %, <0.05]. The serum levels of PC and median D-D in premenopausal breast cancer patients [(112.57±17.86)% and 242.01 ng/ml, respectively] were higher than those in the control group [(105.31±22.31)% and 214.75 ng/ml, respectively, <0.05]. The levels of PT(INR), α2-AP [0.91±0.07 and (111.29±12.54)%, respectively] were lower than those of the control group[0.98±0.15 and (120.17±16.35)%, respectively, <0.05]. The levels of HCY and median D-D in postmenopausal breast cancer patients [(14.25±5.76) μmol/L and 347.53 ng/ml, respectively] were higher than those in the control group [(11.67±2.38) μmol/L and 328.28 ng/ml, <0.05]. The levels of PT, PT(INR), antithrombin Ⅲ (AT-Ⅲ), α2-AP levels [(10.18±0.66) s, 0.87±0.09, (97.30±12.84)% and (110.13±14.96)%] were lower than those in the control group [(10.38±0.61) s, 0.90±0.08, (102.89±9.12)%, and (127.05±12.38)%, respectively, <0.05]. The levels of α2-AP and median D-D in T2-4 stage breast cancer patients [(111.69±14.41)% and 289.25 ng/ml, respectively] were higher than those in Tis-1 stage patients [(108.05±12.37)% and 253.49 ng/ml, respectively, <0.05]. The levels of PT, PT (INR), Fbg, AT-Ⅲ, α2-AP, median D-D [(10.62±0.63) s, 0.95±0.06, (3.04±1.52) g/L, (103.21±9.45)%, (118.72±14.77)% and 331.33 ng/ml, respectively] in breast cancer patients with lymph node metastasis were higher than those of patients without lymph node metastasis [(10.42±0.58) s, 0.93±0.06, (2.52±0.54) g/L, (95.20±13.63)%, (106.91±13.13)% and 263.38 ng/ml, respectively, <0.05]. In non-menopausal breast cancer patients, the level of HCY [(12.63±4.41) μmol/L] in patients with T2-4 stage was higher than that of patients with Tis-1 stage [(10.70±3.49) μmol/L, =0.010], and the level of thrombin time [(19.35±0.90) s] of patients with T2-4 stage was lower than that of patients with Tis-1 stage [(19.79±1.23) s, =0.015]. The levels of PT(INR), Fbg, AT-Ⅲ, α2-AP [0.97±0.56, (3.37±2.34) g/L, (102.38±8.77)% and (120.95±14.06)%] in patients with lymph node metastasis were higher than those of patients without lymph node metastasis [0.94±0.05, (2.36±0.48) g/L, (94.56±14.37)% and (109.51±11.46)%, respectively, <0.05]. Among postmenopausal breast cancer patients, the levels of AT-Ⅲ and α2-AP in T2-4 stage patients [(98.48±11.80)% and (111.84±15.35)%, respectively] were higher than those in patients with the Tis-1 stage [(94.12±14.98)% and (105.49±12.89)%, respectively, <0.05]. The levels of AT-Ⅲ and α2-AP in N1-3 stage patients [(103.74±9.94)% and (117.29±15.23)%] were higher than those in N0 stage patients [(95.75±13.01)% and (108.39±14.42)%, <0.05]. HCY and abnormal coagulation function are related to the risk of breast cancer, T stage and lymph node metastasis in breast cancer patients.
探讨同型半胱氨酸（HCY）及凝血功能指标与乳腺癌发病风险及其临床病理特征的相关性。收集2018年1月至2018年12月在天津医科大学肿瘤医院接受治疗的女性乳腺癌患者（333例）的HCY、凝血功能检测指标及临床病理资料，并选取同期女性乳腺良性疾病患者（225例）作为对照组。计量资料呈正态分布采用t检验进行比较，D - 二聚体数据呈离散分布采用中位数描述，两组比较采用非参数Mann - Whitney U检验。计数资料采用χ²检验进行比较，采用Logistic回归分析进行风险分析。乳腺癌患者组外周血HCY、纤维蛋白原（Fbg）、蛋白C（PC）及D - 二聚体（D - D）中位数水平分别为（13.26±5.24）μmol/L、（2.61±0.83）g/L、（117.55±19.67）%及269.68 ng/ml，高于对照组[分别为（11.58±0.69）μmol/L、（2.49±0.49）g/L、（113.42±19.82）%及246.98 ng/ml，P<0.05]。凝血酶原时间（PT）、PT国际标准化比值（PT(INR)）、α2 - 抗纤溶酶（α2 - AP）水平分别为（10.19±0.63）s、0.91±0.07及（110.64±13.93）%，低于对照组[分别为（10.58±0.65）s、0.93±0.01及（123.81±14.77）%，P<0.05]。绝经前乳腺癌患者血清PC及D - D中位数水平分别为（112.57±17.86）%及242.01 ng/ml，高于对照组[分别为（105.31±22.31）%及214.75 ng/ml，P<0.05]。PT(INR)、α2 - AP水平分别为0.91±0.07及（111.29±12.54）%，低于对照组[分别为0.98±0.15及（120.17±16.35）%，P<0.05]。绝经后乳腺癌患者HCY及D - D中位数水平分别为（14.25±5.76）μmol/L及347.53 ng/ml，高于对照组[分别为（11.67±2.38）μmol/L及328.28 ng/ml，P<0.05]。PT、PT(INR)、抗凝血酶Ⅲ（AT - Ⅲ）、α2 - AP水平分别为（10.18±0.66）s、0.87±0.09、（97.30±12.84）%及（110.13±14.96）%，低于对照组[分别为（10.38±0.61）s、0.90±0.08、（102.89±9.12）%及（127.05±12.38）%，P<0.05]。T2 - 4期乳腺癌患者α2 - AP及D - D中位数水平分别为（111.69±14.41）%及289.25 ng/ml，高于Tis - 1期患者[分别为（108.05±12.37）%及253.49 ng/ml，P<0.05]。有淋巴结转移乳腺癌患者PT、PT(INR)、Fbg、AT - Ⅲ、α2 - AP、D - D中位数水平分别为（10.62±0.63）s、0.95±0.06、（3.04±1.52）g/L、（103.21±9.45）%、（118.72±14.77）%及331.33 ng/ml，高于无淋巴结转移患者[分别为（10.42±0.58）s、0.93±0.06、（2.52±0.54）g/L、（95.20±13.63）%、（106.91±13.13）%及263.38 ng/ml，P<0.05]。在非绝经乳腺癌患者中，T2 - 4期患者HCY水平为（12.63±4.41）μmol/L，高于Tis - 1期患者[（10.70±3.49）μmol/L，P = 0.010]，T2 - 4期患者凝血酶时间为（19.35±0.90）s，低于Tis - 1期患者[（19.79±1.23）s，P = 0.015]。有淋巴结转移患者PT(INR)、Fbg、AT - Ⅲ、α2 - AP水平分别为0.97±0.56、（3.37±2.34）g/L、（102.38±8.77）%及（120.95±14.06）%，高于无淋巴结转移患者[分别为0.94±0.05、（2.36±0.48）g/L、（94.56±14.37）%及（109.51±11.46）%，P<0.05]。在绝经后乳腺癌患者中，T2 - 4期患者AT - Ⅲ及α2 - AP水平分别为（98.48±11.80）%及（111.84±15.35）%，高于Tis - 1期患者[分别为（94.12±14.98）%及（105.49±12.89）%，P<0.05]。N1 - 3期患者AT - Ⅲ及α2 - AP水平分别为（103.74±9.94）%及（117.29±15.23）%，高于N0期患者[分别为（95.75±13.01）%及（108.39±14.42）%，P<0.05]。HCY及异常凝血功能与乳腺癌患者发病风险、T分期及淋巴结转移相关。
