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目的探讨联合检测血清同型半胱氨酸(Hcy)、糖链抗原15-3(CA15-3)及叶酸(FA)水平在乳腺癌手术前后及复发转移中的临床价值。方法选择2010年1月至2010年12月间在我院接受手术治疗的原发性乳腺癌患者387例,比较手术前后的血清Hcy、CA15-3及FA水平,根据术后5年的随访结果分为复发组(47例)和未复发组(340例),比较两组术后的血清Hcy、CA15-3及FA水平,分析复发转移性乳腺癌血清Hcy、CA15-3及FA水平间的相关性。结果乳腺癌患者术后1个月血清Hcy和CA15-3水平分别为(11.83±4.25)μmol/L和(13.02±3.01)U/ml,低于术前的(17.27±6.82)μmol/L和(37.29±15.92)U/ml,而术后1个月的血清FA水平为(7.84±3.17)ng/ml,高于术前的(5.16±2.36)ng/ml,差异均有统计学意义(P<0.05);复发组术后1个月的血清Hcy和CA15-3水平分别为(16.08±5.93)μmol/L和(28.41±13.85)U/ml,高于未复发组的(11.92±4.31)μmol/L和(14.25±2.96)U/ml,而复发组FA水平为(5.12±2.21)ng/ml,低于未复发组的(7.85±3.09)ng/ml,差异均有统计学意义(P<0.05);复发组的血清Hcy、CA15-3及FA的异常率高于未复发组(P<0.05),且复发转移性乳腺癌患者中,Ⅲ、Ⅳ期患者的Hcy、CA15-3及FA异常率均高于Ⅰ、Ⅱ期,差异有统计学意义(P<0.05);复发转移性乳腺癌患者血清FA水平与Hcy、CA15-3水平呈负相关(r=-0.286、-0.346,P<0.05),Hcy和CA15-3水平呈正相关(r=0.402,P<0.05)。结论复发转移性乳腺癌患者的血清Hcy、CA15-3水平较高,FA水平较低,可能预测乳腺癌患者复发转移。
Objective To investigate the clinical value of combined detection of serum homocysteine (Hcy), carbohydrate antigen 15-3 (CA15-3) and folic acid (FA) in breast cancer before and after operation and recurrence and metastasis. Methods 387 primary breast cancer patients undergoing surgery in our hospital from January 2010 to December 2010 were selected. The levels of serum Hcy, CA15-3 and FA before and after surgery were compared. According to the follow-up results of 5 years after operation The patients were divided into recurrent group (n = 47) and non-recurrent group (n = 340). Serum levels of Hcy, CA15-3 and FA were compared between the two groups. The serum levels of Hcy, CA15-3 and FA in relapsed metastatic breast cancer Correlation. Results The serum levels of Hcy and CA15-3 at 1 month after operation in patients with breast cancer were (11.83 ± 4.25) μmol / L and (13.02 ± 3.01) U / ml, respectively, which were lower than those of 17.27 ± 6.82 μmol / L and (37.29 ± 15.92) U / ml, while the serum FA level at 1 month after operation was (7.84 ± 3.17) ng / ml, which was significantly higher than that of preoperative (5.16 ± 2.36) ng / ml (16.08 ± 5.93) μmol / L and (28.41 ± 13.85) U / ml respectively, which were significantly higher than those in the non-recurrence group (11.92 ± 4.31, P <0.05) ) (μmol / L) and (14.25 ± 2.96) U / ml respectively, while the level of FA in recurrence group was (5.12 ± 2.21) ng / ml, which was lower than that in non recurrence group (7.85 ± 3.09) ng / (P <0.05). The abnormal rates of serum Hcy, CA15-3 and FA in the relapse group were higher than those in the non-recurrence group (P <0.05), and the recurrence of metastatic breast cancer in patients with stage Ⅲ, Ⅳ Hcy, CA15- 3 and FA were significantly higher than those in stage Ⅰ and Ⅱ (P <0.05). The serum levels of FA in patients with recurrent metastatic breast cancer were negatively correlated with the levels of Hcy and CA15-3 (r = -0.286, - 0.346, P <0.05). There was a positive correlation between Hcy and CA15-3 levels (r = 0.402, P <0.05). Conclusions Patients with recurrent metastatic breast cancer have higher serum Hcy, CA15-3 levels and lower FA levels, which may predict the recurrence and metastasis of breast cancer patients.