Abstract:

Objective　To analyze the relationship between axillary lymph node metastasis (ALN) and prognosis of patients with breast cancer by automated breast volume imaging (ABVS) combined with miR-22-3p and platelet endothelium-derived factor (PDGF). Methods　This was a retrospective study. Ninety-seven patients with breast cancer treated at Hanzhong Central Hospital from January 2021 to September 2023 were selected, including 25 menopausal patients. They were 19-75 years old. The level of PDGF was detected by the enzyme linked immunosorbent assay before the surgery; the ABVS technique was used for the examination. The real-time fluorescence quantitative PCR was used to detect serum miR-22-3p. All the patients were treated with the modified radical operation. According to postoperative pathological results whether they had ALN, the patients were divided into an occurrence group (20 cases) and a non-occurrence group (77 cases). The Pearson correlation was used to analyze the relationship between ABVS technology combined with miR-22-3p and PDGF levels and the occurrence of ALN in the patients. The patients were followed up for 1 year by outpatient recheck or telephone. The recurrence, death, and survival were counted, and the patients were divided into a poor prognosis group (17 cases) and a good prognosis group (cases) according to their prognosis. The basic data were compared between the poor prognosis group and the good prognosis group. The binary logistic stepwise regression model was used to analyze the factors affecting the patients' prognosis. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic efficacy. t and χ² tests were used for the statistical analysis. Results　The level of miR-22-3p in the occurrence group was lower than that in the non-occurrence group (0.81±0.23 vs. 1.14±0.28); the proportions of the patients with lesion size ≥2 cm and distance between lesion and nipple and level of PDGF in the occurrence group was higher than those in the non-occurrence group [60.00% (12/20) vs. 29.87% (23/77), 65.00% (13/20) vs. 32.47% (25/77), and (602.30±52.56) ng/L vs. (543.85±49.74) ng/L]; there were statistical differences (all P<0.05). The results of Pearson correlation analysis showed that miR-22-3p was negatively correlated with the occurrence of ALN in the patients (r=-0.592; P<0.001); the lesion size ≥2 cm, distance between lesion and nipple ≥2 cm, and level of PDGF were positively correlated with the occurrence of ALN in the patients (r=0.612, 0.601, and 0.584; all P<0.001). The level of miR-22-3p in the poor prognosis group was lower than that in the good prognosis group (0.86±0.27 vs. 1.22±0.36); the level of PDGF and the proportions of the patients with TNM stage Ⅲ-Ⅳ, irregular edge, and micro-calcification foci in the poor prognosis group were higher than those in the good prognosis group [(586.32±56.41) ng/L vs. (521.31±54.02) ng/L, 58.82% (10/17) vs. 26.25% (21/80), 64.71% (11/17) vs. 30.00% (24/80), and 70.59% (12/17) vs. 36.25% (29/80)]; there were statistical differences (all P<0.05). The binary logistic regression analysis showed that the levels of miR-22-3p and PDGF, TNM stage Ⅲ-Ⅳ, micro-calcification foci, and irregular edge were the factors affecting the patients' poor prognosis (all P<0.05). The ROC analysis showed that the combination of miR-22-3p, PDGF, TNM stage Ⅲ-Ⅳ, micro-calcification foci, and irregular edge had high value in the prediction of the patients' poor prognosis (area under the curve=0.896). Conclusions　ABVS technology combined with miR-22-3p and PDGF has good efficacy in the evaluation of poor prognosis in patients with breast cancer. The ABVS technology combined with miR-22-3p and PDGF is correlated with the occurrence of ALN in patients with breast cancer.

Key words:

Automated breast volume imaging, MiR-22-3p, Platelet endothelium-derived factor, Breast cancer, Axillary lymph node metastasis,  , Prognosis

摘要：

目的　分析自动乳腺容积成像（ABVS）技术联合miR-22-3p、血小板内皮衍生因子（PDGF）对乳腺癌腋窝淋巴结转移（ALN）及与预后的关系。方法　采用回顾性分析，选取2021年1月至2023年9月汉中市中心医院收治的97例乳腺癌患者，其中年龄19～75岁，绝经患者25例，于术前通过酶联免疫吸附法检测PDGF水平，使用ABVS技术检查，用实时荧光定量PCR法检测血清miR-22-3p。均接受改良根治术治疗，根据术后病理结果将有无发生ALN分为发生组（20例）和未发生组（77例）。采用Pearson相关性分析ABVS技术联合miR-22-3p、PDGF水平与乳腺癌患者发生ALN的关系；门诊复查或电话方式随访1年，统计患者复发、死亡、生存等发生情况，根据患者预后状况分为预后不良组（17例）和预后良好组（80例），比较两组患者基础资料；采取二元logistic逐步回归模型分析影响乳腺癌患者预后的因素；绘制受试者操作特征曲线（ROC）评估诊断效能。统计学方法采用t检验、χ²检验。结果　发生组miR-22-3p水平为0.81±0.23，低于未发生组的1.14±0.28；病变大小≥2 cm、病灶距乳头≥2 cm及PDGF水平均高于未发生组［60.00%（12/20）比29.87%（23/77）、65.00%（13/20）比32.47%（25/77）、（602.30±52.56）ng/L比（543.85±49.74）ng/L］；差异均有统计学意义（均P<0.05）。经Pearson相关性分析结果显示，miR-22-3p与乳腺癌患者发生ALN呈负相关（r=-0.592，P<0.001）；病变大小≥2 cm、病灶距乳头≥2 cm、PDGF水平与乳腺癌患者发生ALN呈正相关（r=0.612、0.601、0.584，均P<0.001）。预后不良组miR-22-3p水平为0.86±0.27，低于预后良好组的1.22±0.36；PDGF水平及TNM分期Ⅲ～Ⅳ期、边缘不规整、有微小钙化灶均高于预后良好组［（586.32±56.41）ng/L比（521.31±54.02）ng/L、58.82%（10/17）比26.25%（21/80）、64.71%（11/17）比30.00%（24/80）、70.59%（12/17）比36.25%（29/80）］；差异均有统计学意义（均P<0.05）。二元logistic回归分析显示，miR-22-3p、PDGF、TNM分期Ⅲ～Ⅳ期、有微小钙化灶、边缘不规整为影响乳腺癌患者预后不良的影响因素（均P<0.05）。ROC分析显示，miR-22-3p、PDGF、TNM分期Ⅲ～Ⅳ期、有微小钙化灶、边缘不规整联合预测乳腺癌患者预后不良的价值较高（曲线下面积=0.896）。结论　ABVS技术与miR-22-3p、PDGF联合检测评估乳腺癌患者预后不良的效能较好，且ABVS技术联合miR-22-3p、PDGF与乳腺癌患者ALN的发生存在一定相关性。

关键词:

自动乳腺容积成像技术, miR-22-3p, 血小板内皮衍生因子, 乳腺癌, 腋窝淋巴结转移, 预后