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目的:研究新辅助化疗(NAC)对乳腺癌患者血清hMAM水平的影响。方法:应用酶联免疫吸附法(ELISA)测定164例乳腺癌患者NAC前后及手术后血清hMAM水平。结果:在化疗有效(CR、PR)组中,NAC后hMAM水平分别为20.59(6.27)和28.32(13.03)ng/mL,NAC前分别为39.87(12.91)和35.56(20.25)ng/mL,两者差异有统计学意义,P<0.01;而化疗无效组(SD+PD)NAC前后血清hMAM水平差异无统计学意义。hMAM的下降水平与肿瘤最大径有关,T1组为11.73(21.57)ng/mL,T2组为18.55(21.88)ng/mL,T3组为26.99(21.12)ng/mL,3组差异有统计学意义,P=0.005。hMAM的下降水平还与临床化疗效果有关,CR组为43.35(15.95)ng/mL,PR组为22.15(16.21)ng/mL,SD+PD组为0.53(17.18)ng/mL,3组差异有统计学意义,P=0.000。hMAM的下降水平与临床分期、组织学分级、淋巴结状态、年龄、月经状态、分子分型、病理学类型以及ER、PR、HER-2、p53和Ki-67表达等无关。结论:血清hMAM水平变化与下降水平可作为NAC常规疗效判断标准的补充,有望成为判断乳腺癌患者病情发展和预后的新指标。
Objective: To investigate the effect of neoadjuvant chemotherapy (NAC) on serum hMAM levels in patients with breast cancer. Methods: Serum hMAM levels were measured before and after NAC in 164 breast cancer patients by enzyme-linked immunosorbent assay (ELISA). Results: The hMAM levels after NAC were 20.59 (6.27) and 28.32 (13.03) ng / mL respectively in the chemotherapy-effective (CR, PR) group and 39.87 (12.91) and 35.56 (P <0.01). However, there was no significant difference in serum hMAM level between NAC and SD + PD patients before and after chemotherapy. The decrease of hMAM was related to the maximum diameter of the tumor, which was 11.73 (21.57) ng / mL in T1 group, 18.55 (21.88) ng / mL in T2 group and 26.99 (21.12) ng / mL in T3 group , P = 0.005. The decrease of hMAM was also related to the effect of chemotherapy. The CR level was 43.35 (15.95) ng / mL in PR group, 22.15 (16.21) ng / mL in PR group and 0.53 (17.18) ng / mL in SD + PD group. Statistical significance, P = 0.000. The decline of hMAM was not associated with clinical stage, histological grade, lymph node status, age, menstrual status, molecular typing, pathological type, ER, PR, HER-2, p53 and Ki-67 expression. Conclusion: The change of serum hMAM level and the level of decrease can be used as the standard of NAC routine curative effect, which is expected to be a new index to judge the progression of disease and prognosis of breast cancer patients.