中国癌症杂志 ›› 2019, Vol. 29 ›› Issue (5): 372-378.doi: 10.19401/j.cnki.1007-3639.2019.05.007

• 论著 • 上一篇    下一篇

V i t D / V D R 与乳腺癌患者免疫状态、临床特征及预后的相关性研究

殷隽逸,王雅灵,胡海燕   

  1. 上海交通大学附属第六人民医院肿瘤内科,上海 200233
  • 出版日期:2019-05-30 发布日期:2019-06-03
  • 通信作者: 胡海燕 E-mail: xuri1104@163.com
  • 基金资助:
    国家自然科学基金(81372873)。

Relationship between VitD/VDR and clinical characteristics of breast cancer

YIN Junyi, WANG Yaling, HU Haiyan   

  1. Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Published:2019-05-30 Online:2019-06-03
  • Contact: HU Haiyan E-mail: xuri1104@163.com

摘要: 背景与目的:维生素D(vitamin D,VitD)是一种类固醇激素,外周血25羟基VitD[25-hydroxy VitD,25(OH)D]的血清浓度被认为是体内VitD状态的主要生物标志物,通过检测乳腺癌患者外周血清中25(OH)D的水平,探讨VitD与乳腺癌患者各项临床特征的相关性。方法:对比2015年1月—2018年7月上海交通大学附属第六人民医院收治的乳腺癌患者109例、乳腺良性肿瘤患者50例及健康体检者2 000例的外周血血清中25(OH)D的水平差异,并进一步检测乳腺癌患者的T细胞免疫功能、NK细胞水平,同时应用免疫组织化学方法检测乳腺癌患者癌组织中VitD受体(VitD receptor,VDR)的表达。结果:乳腺癌患者外周血中25(OH)D水平显著低于乳腺良性肿瘤患者和健康体检者,差异有统计学意义(P <0.05)。乳腺良性肿瘤患者与健康体检者外周血25(OH)D水平无明显差异(P>0.05)。乳腺癌患者外周血25(OH)D水平与患者T细胞免疫功能(CD4+/CD8+比值)、临床分期、淋巴结是否受累、是否骨转移、孕激素受体(progesterone receptor,PR)是否阳性均有显著相关性(P<0.05),而与肿瘤大小、NK细胞水平、雌激素受体(estrogen receptor,ER)是否阳性无显著相关性(P>0.05)。乳腺癌组织VDR的表达与乳腺癌患者的T细胞免疫功能、临床分期、肿瘤大小、是否骨转移、是否淋巴结转移均无显著相关性(P>0.05),而与ER、PR是否阳性具有显著相关性(P <0.05)。结论:外围血中VitD水平低可能与乳腺癌发病风险高、T细胞免疫功能低下及预后差有关。

关键词: 25羟基维生素D, 维生素D受体, 乳腺癌

Abstract: Background and purpose: Vitamin D (VitD) is a steroid hormone. This study aimed to detect the level of 25-hydroxy VitD [25 (OH) D] which is a serum biomarker of VitD status in peripheral blood of patients with breast cancer, and to explore the correlation between VitD and clinicopathologic characteristics of breast cancer patients. Methods: We measured the level of 25 (OH) D in 109 breast cancer patients, 50 patients with benign breast tumors and 2 000 healthy subjects in our hospital from January 2015 to July 2018 by a chemiluminescent immunoassay method. Flow cytometry was used to detect the immune function of T cells and the level of NK cells in the peripheral blood of breast cancer patients. Furthermore,the expression of VitD receptor (VDR) in breast cancer tissues was detected by immunohistochemistry. Results: The level of 25 (OH) D in peripheral blood of patients with breast cancer was significantly lower compared with patients with benign breast tumors or healthy subjects (P<0.05). There was no significant difference in peripheral blood 25 (OH) D levels between patients with benign breast tumors and healthy subjects (P>0.05). The level of 25 (OH) D in breast cancer patients was significantly associated with the immune function of T cells (CD4+/CD8+ ratio), clinical stage, lymph node metastasis, bone metastasis and progesterone receptor (PR) positivity, whereas serum 25 (OH) D level had no relation to the tumor size, the quantity of NK cells and the level of estrogen receptor (ER) (P>0.05). There was a statistically significant correlation between the expression of VDR in breast cancer tissues and the level of hormone receptor (ER and PR) (P<0.05), while positive expression of VDR was not associated with the immune function of T cells, clinical stage, tumor size, bone metastasis and lymph node metastasis (P>0.05). Conclusion: Low levels of VitD in peripheral blood may be associated with high risk of breast cancer, poor T cell immune function and poor prognosis.

Key words: 25-hydroxy vitamin D, Vitamin D receptor, Breast cancer