Hu Jinxi, Cai Yangjun, Chen Yijun, Zhu Xiaoli
Department of Oncological Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, People's Republic of China.
Department of Laboratory Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, People's Republic of China.
Breast Cancer (Dove Med Press). 2024 Nov 7;16:735-743. doi: 10.2147/BCTT.S491523. eCollection 2024.
The role of serum total bilirubin (TB) in cancer has been a subject of controversy, as has the role of its subtypes, particularly serum direct bilirubin (DB). The aim of the present study was to investigate the association between serum DB levels and breast cancer, as well as to assess the diagnostic utility of serum DB in breast cancer.
A total of 5299 patients diagnosed with breast cancer for the first time at Taizhou Hospital of Zhejiang Province were included in the study, and 10028 healthy physical examination subjects were included as healthy controls. Logistics regression was used to investigate the relationship between serum DB and breast cancer, and the value of serum DB in the diagnosis of breast cancer was assessed by means of receiver operator characteristic (ROC) curve analysis.
The serum DB concentration in the breast cancer group was significantly higher than the healthy controls ( < 0.001). Multivariate logistic regression results show that serum DB was an independent risk factor for breast cancer (odds ratio [OR]=4.504, 95% confidence interval [CI]: 4.200-4.831). Subjects with a serum DB concentration in the fourth quartile had a higher risk of breast cancer occurrence compared to those in the first quartile after adjusting for age (OR = 7.155, 95%CI: 6.474-7.907). The optimal cut-off value of serum DB for diagnosing breast cancer was determined to be 2.75 μmol/L, with an area under the curve (AUC) of 0.712 (95% CI: 0.703-0.722). This value exhibited good specificity (77.0%) and negative predictive value (77.8%).
Serum DB was identified as a risk factor for breast cancer, demonstrating good diagnostic potential for the disease. These findings suggest that serum DB could serve as a promising serum molecular marker for breast cancer.
血清总胆红素（TB）在癌症中的作用一直存在争议，其亚型尤其是血清直接胆红素（DB）的作用也同样如此。本研究的目的是探讨血清DB水平与乳腺癌之间的关联，并评估血清DB在乳腺癌诊断中的效用。
本研究纳入了浙江省台州医院首次诊断为乳腺癌的5299例患者，并纳入10028例健康体检者作为健康对照。采用逻辑回归分析血清DB与乳腺癌之间的关系，并通过受试者工作特征（ROC）曲线分析评估血清DB在乳腺癌诊断中的价值。
乳腺癌组血清DB浓度显著高于健康对照组（<0.001）。多因素逻辑回归结果显示，血清DB是乳腺癌的独立危险因素（比值比[OR]=4.504，95%置信区间[CI]：4.200-4.831）。在调整年龄后，血清DB浓度处于第四四分位数的受试者患乳腺癌的风险高于第一四分位数的受试者（OR=7.155，95%CI：6.474-7.907）。诊断乳腺癌的血清DB最佳截断值确定为2.75μmol/L，曲线下面积（AUC）为0.712（95%CI：0.703-0.722）。该值具有良好的特异性（77.0%）和阴性预测值（77.8%）。
血清DB被确定为乳腺癌的危险因素，并显示出对该疾病良好的诊断潜力。这些发现表明血清DB有望成为乳腺癌的血清分子标志物。
