施静　周春龙　张海霞　欧雪峰　曾锦婷　张燕　孔秀平

【摘要】 目的：了解不同臨床特征乳腺癌患者血清中血管内皮细胞生长因子（VEGF）、VitD、铁蛋白（SF）、趋化因子20（CCL20）及结缔组织生长因子（CTGF）水平表达情况，并探讨其临床意义。方法：选择2018年7月-2020年4月在深圳市宝安区福永人民医院和龙华区人民医院妇产科确诊为乳腺癌的103例患者作为乳腺癌组，89例乳腺良性肿瘤患者作为乳腺良性肿瘤组，同时选取120名健康体检者作为对照组。分别比较三组血清中VEGF、VitD、SF、CCL20及CTGF水平;比较乳腺癌组中不同临床特征者VEGF、VitD、SF、CCL20及CTGF水平，并分析各指标间的相关性。结果：乳腺癌组血清中VEGF、SF、CCL20及CTGF水平均高于乳腺良性肿瘤组和对照组，而VitD水平明显低于乳腺良性肿瘤组和对照组，差异均有统计学意义（P<0.05）。乳腺良性肿瘤组SF和CTGF水平均高于对照组（P<0.05）;Ⅲ、Ⅳ期和癌瘤长径>5 cm、有淋巴结转移及中、低度组织分化的乳腺癌患者血清中VEGF、SF、CCL20及CTGF水平明显更高，而VitD水平更低（P<0.05）。乳腺癌患者血清中VEGF、SF、CCL20及CTGF水平两两之间均呈正相关，而VitD水平与各指标均呈负相关（P<0.05）。结论：乳腺癌患者血清中VEGF、SF、CCL20及CTGF水平明显升高，而VitD水平明显降低，且与乳腺癌的临床分期、癌瘤长径、是否有淋巴结转移及组织分化严重程度有关。因此，加强VEGF、VitD、SF、CCL20及CTGF水平检测对乳腺癌的早期诊断及不同临床特征分析具有一定的参考价值。

【关键词】 乳腺癌 血管内皮细胞生长因子 VitD 铁蛋白 趋化因子20 结缔组织生长因子

[Abstract] Objective： To investigate the expression levels of vascular endothelial cell growth factor （VEGF）， VitD， ferritin （SF）， chemokine 20 （CCL20） and connective tissue growth factor （CTGF） in serum of breast cancer patients with different clinical characteristics， and to explore their clinical significance. Method： A total of 103 patients diagnosed with breast cancer in the department of obstetrics and gynecology of Shenzhen Baoan District Fuyong Peoples Hospital and Longhua District Peoples Hospital from July 2018 to April 2020 were selected as the breast cancer group， and 89 patients with benign breast tumor were selected as the breast cancer group. Meanwhile， 120 healthy subjects were selected as the control group. The levels of VEGF， VitD， SF， CCL20 and CTGF in serum of the three groups were compared. The levels of VEGF， VitD， SF， CCL20 and CTGF in breast cancer group with different clinical characteristics were compared， and the correlation among the indicators was analyzed. Result： The serum levels of VEGF， SF， CCL20 and CTGF in breast cancer group were higher than those in benign breast tumor group and control group， while the level of VitD was significantly lower than those in benign breast tumor group and control group， with statistical significance （P<0.05）. The levels of SF and CTGF in benign breast tumor group were higher than those in control group （P<0.05）. The serum levels of VEGF， SF， CCL20 and CTGF were significantly higher and the level of VitD was lower in the breast cancer patients with Ⅲ and Ⅳ stage， >5 cm tumor length and diameter， lymph node metastasis and moderate and low tissue differentiation （P<0.05）. The serum levels of VEGF， SF， CCL20 and CTGF in breast cancer patients were positively correlated with each other， while the level of VitD was negatively correlated with each index （P<0.05）. Conclusion： The levels of VEGF， SF， CCL20 and CTGF in serum of breast cancer patients are significantly increased， while the level of VitD is significantly decreased， which are related to the clinical stage of breast cancer， tumor length and diameter， lymph node metastasis and the severity of tissue differentiation. Therefore， strengthening the detection of VEGF， VitD， SF， CCL20 and CTGF levels have certain reference value for the early diagnosis of breast cancer and the analysis of different clinical characteristics.

[Key words] Breast cancer VEGF VitD SF CCL20 CTGF

First-authors address： Shenzhen Baoan District Fuyong Peoples Hospital， Shenzhen 518103， China

doi：10.3969/j.issn.1674-4985.2021.19.002

乳腺癌是临床上目前最为常见的一种女性恶性肿瘤之一，其发病率呈逐年上升趋势，且不断年轻化，严重影响女性身心健康和生活质量[1-3]。乳腺癌发病病因及机制目前尚未完全明确，有研究表明，乳腺癌发病可能与种族、年龄、遗传、饮食结构及激素水平等多种因素[4-5]。乳腺癌患者致死的主要原因是癌细胞的浸润和转移，而癌细胞的浸润和转移与肿瘤细胞的恶性增生、组织新生血管的形成、黏附、迁移及分泌蛋白降解基质等多种因素的调控有关[6-8]。……