背景:乳腺癌的早期诊断对乳腺癌患者的治疗和预后至关重要。我们的目的是探索更实用有效的诊断方法,以促进乳腺癌患者的早期治疗和改善预后。
方法:Mann-WhitneyU检验,接收机工作特性曲线,尤登指数,卡方检验,和Fisher的精确检验用于确定血浆硫氧还蛋白还原酶(TrxR)是否可用于乳腺癌的临床诊断。使用Wilcoxon符号秩检验来验证血浆TrxR活性评估的预后潜力。
结果:共纳入761例患者,其中乳腺癌537例,乳腺良性疾病224例。乳腺癌组血浆TrxR活性[8.0(6.0,9.45)U/mL]显著高于良性组[3.05(1.20,6.275)U/mL]。TrxR对乳腺癌的诊断效率高于其他常规乳腺癌生物标志物,曲线下面积为0.821(95%CI=0.791-0.852)。此外,TrxR可与常规肿瘤标志物联合使用以进一步提高诊断效率。鉴别良恶性疾病的最佳TrxR阈值为7.45U/mL。我们检测了333例乳腺癌患者抗肿瘤治疗前后血浆TrxR活性和血清肿瘤标志物,发现两者的变化趋势基本一致,治疗后血浆TrxR活性显着降低。
结论:血浆TrxR活性可作为乳腺癌诊断和疗效评估的合适生物标志物。
BACKGROUND: Early diagnosis of breast cancer is critical to the treatment and prognosis of breast cancer patients. Our aim is to explore more practical and effective diagnostic methods to facilitate early treatment and improve prognosis for breast cancer patients.
METHODS: The Mann-Whitney U test, receiver operating characteristic curve, Youden index, Chi-square test, and Fisher\'s exact test were used to determine whether plasma thioredoxin reductase (
TrxR) could be used for the clinical diagnosis of breast cancer. The Wilcoxon signed-rank test was used to validate the prognostic potential of plasma TrxR activity assessment.
RESULTS: A total of 761 patients were included, including 537 cases of breast cancer and 224 cases of benign breast diseases. Plasma
TrxR activity in the breast cancer group [8.0 (6.0, 9.45) U/mL] was significantly higher than that in the benign group [3.05 (1.20, 6.275) U/mL]. The diagnostic efficiency of
TrxR for breast cancer was higher than that of other conventional breast cancer biomarkers, with an area under the curve of 0.821 (95% CI = 0.791-0.852). In addition, TrxR can be used in combination with conventional tumor markers to further improve the diagnostic efficiency. The optimal
TrxR threshold for identifying benign and malignant diseases is 7.45 U/mL. We detected plasma
TrxR activity and serum tumor markers before and after antitumor therapies in 333 breast cancer patients and found that their trends were basically the same, with a significant decrease in plasma TrxR activity after treatment.
CONCLUSIONS: Plasma TrxR activity can be used as a suitable biomarker for breast cancer diagnosis and efficacy assessment.