目的:观察乳腺癌患者血清及乳腺组织中结合素4的表达并探讨其临床意义。方法:选择2007年6月至2008年12月哈尔滨医科大学附属三院收集的40例乳腺癌患者和20例乳腺良性肿瘤患者为研究对象,分为正常对照组、乳腺癌组、乳腺良性肿瘤组,采用Elisa法和免疫组化法对所选择的血清及组织标本中nectin-4及血清中癌胚抗原(CEA)、CA153的表达进行检测。结果:①nectin-4的阳性表达定位于细胞质和细胞膜,其在乳腺癌组织中的阳性表达率显著高于乳腺良性组织(P<0.05);nectin-4的表达与患者的年龄、临床分期无关(P>0.05),但与乳腺癌的病理类型、腋窝淋巴结转移与否、Her-2、ER和PR的表达均显著相关(P<0.05)。②乳腺癌组血清nectin-4表达水平最高,为238±4.95 pg/ml;乳腺良性病变组为120±3.28 pg/ml;正常对照组为104±5.86pg/ml,三者之间比较,差别有统计学意义(P<0.01)。③与正常对照组、乳腺良性病变组比较,乳腺癌组血清CEA、CA153水平均明显升高,差异有显著统计学意义(P<0.01)。④nectin-4、CEA和CA153诊断乳腺癌的敏感性分别为31.67%、43.33%、28.33%,特异性分别为92.50%、95%、95%,三者联合检测诊断乳腺癌的敏感性较单独检测显著升高(P<0.05),可达81.67%。结论:Nectin-4在乳腺癌中高表达,且与乳腺癌的病理类型、腋窝淋巴结转移与否、Her-2、ER和PR的表达均呈显著相关,通过联合检测血清nectin-4、CEA和CA153水平可显著提高乳腺癌诊断的敏感性,有助于乳腺癌的治疗和预后评估,值得临床进一步深入研究。 Objective: To observe the expression of integrin-4 in serum and breast tissue of patients with breast cancer and to explore its clinical significance. Methods: Forty patients with breast cancer and 20 patients with benign breast tumor collected from the Affiliated Hospital of Harbin Medical University from June 2007 to December 2008 were selected as the research object and divided into normal control group, breast cancer group, benign breast tumor group The expression of nectin-4, CEA and CA153 in serum and tissue samples were detected by Elisa method and immunohistochemistry. Results: ① The positive expression of nectin-4 localized in cytoplasm and cell membrane, and the positive expression rate of nectin-4 in breast cancer tissues was significantly higher than that in benign breast tissues (P <0.05). The expression of nectin-4 was not related to the age and clinical stage P> 0.05), but there was a significant correlation between the expression of Her-2, ER and PR in axillary lymph node metastasis and axillary lymph node metastasis (P <0.05). ② The expression of nectin-4 in breast cancer group was the highest (238 ± 4.95 pg / ml), that of benign breast disease group was 120 ± 3.28 pg / ml, that in the normal control group was 104 ± 5.86pg / ml There was statistical significance (P <0.01). ③ Compared with normal control group and benign breast disease group, the levels of serum CEA and CA153 in breast cancer group were significantly increased, the difference was statistically significant (P <0.01). The sensitivity of nectin-4, CEA and CA153 in the diagnosis of breast cancer were 31.67%, 43.33% and 28.33% respectively, the specificity was 92.50%, 95% and 95% Significantly increased (P <0.05), up to 81.67%. CONCLUSION: Nectin-4 is highly expressed in breast cancer, and it has a significant correlation with the pathological types, metastasis of axillary lymph nodes, and the expression of Her-2, ER and PR in breast cancer. Combined detection of nectin-4, CEA and CA153 Levels can significantly improve the sensitivity of breast cancer diagnosis, contribute to the treatment of breast cancer and prognosis, it is worth further study in the clinic.