血清C肽和胰岛素样生长因子结合蛋白3与乳腺癌患者死亡风险相关性分析

doi:10.3969/j.issn.1673-8640.2022.01.007

摘要/Abstract

摘要：

目的探讨血清C肽和胰岛素样生长因子结合蛋白3（IGFBP-3）与乳腺癌患者死亡风险的相关性。方法选取乳腺癌患者339例,随访2~4年。收集所有患者的一般临床资料（年龄、性别、体力活动、吸烟史、饮酒史、身高、体质量、腰围）,计算体质量指数（BMI）,检测C肽、空腹胰岛素（FINS）、空腹血糖（FBG）、血清肌酐（SCr）和IGFBP-3水平。采用Cox回归分析评估各项指标与乳腺癌患者死亡风险的关系。结果死亡组BMI、腰围及血清C肽、IGFBP-3水平均显著高于生存组（P<0.05）,其他指标2个组之间差异均无统计学意义（P>0.05）。根据C肽的四分位数对乳腺癌患者进行分组,与C肽≤0.39 nmol/L组比较,C肽0.40~0.62 nmol/L组、C肽0.63~1.02 nmol/L组、C肽≥1.03 nmol/L组血清IGFBP-3水平均显著升高（P<0.05）,且趋势P<0.000 1,表明IGFBP-3与C肽有关。根据FINS的四分位数将乳腺癌患者分为4组,4组之间血清IGFBP-3水平差异均无统计学意义（P>0.05）,且趋势P>0.05,表明IGFBP-3与FINS水平无关。Cox回归分析结果显示,充分校正混杂因素后,C肽和IGFBP-3与乳腺癌患者死亡风险有关[风险比（HR）值分别为1.58、1.02,95%可信区间（CI）分别为1.09~2.66、1.01~1.91,P值分别为0.02、0.01]。结论 C肽和IGFBP-3与乳腺癌患者死亡风险有关。

关键词: C肽, 胰岛素样生长因子结合蛋白3, 乳腺癌

Abstract:

Objective To investigate the correlation between serum C peptide and insulin-like growth factor binding protein 3（IGFBP-3） and the risk of breast cancer patient death. Methods Totally,339 patients with breast cancer were enrolled and followed up for 2-4 years. The general clinical data（age,sex,physical activity,smoking history,drinking history,height,body mass and waist circumference） of all the patients were collected,the body mass index（BMI） was calculated,and the levels of C peptide,fasting insulin（FINS）,fasting blood glucose（FBG）,serum creatinine（SCr） and IGFBP-3 were determined. Cox regression analysis was used to assess the relationship between the indicators and the risk of breast cancer patient death. Results BMI,waist circumference,C peptide and IGFBP-3 levels in death group were higher than those in survival group（P<0.05）. There was no statistical significance in the other indicators between the 2 groups（P>0.05）. According to the four percentiles of C peptide,the patients were classified into 4 groups. Compared with those of C peptide≤0.39 nmol/L,serum IGFBP-3 levels of C peptide 0.40-0.62 nmol/L group,C peptide 0.63-1.02 nmol/L group,C peptide≥1.03 nmol/L group were increased（P<0.05） with the trend of P<0.000 1,indicating that it was related to C peptide. According to FINS's four percentiles,4 subgroups of breast cancer patients were grouped. There was no statistical significance in serum IGFBP-3 level among the 4 groups（P>0.05） with the trend of P>0.05,indicating that serum IGFBP-3 had no relation with FINS level. Cox regression analysis showed that C peptide and IGFBP-3 were related to the risk of breast cancer patient death after fully correcting the confounding factors. The hazard ratios（HR） were 1.58 and 1.02,respectively,the 95% confidence intervals（CI） ranged from 1.09 to 2.66 and from 1.01 to 1.91,and the P values were 0.02 and 0.01. Conclusions C peptide and serum IGFBP-3 are related to the risk of breast cancer patient death.

Key words: C peptide, Insulin-like growth factor binding protein-3, Breast cancer

中图分类号:

R446.1

张馨月, 陈亮, 郑宇. 血清C肽和胰岛素样生长因子结合蛋白3与乳腺癌患者死亡风险相关性分析[J]. 检验医学, 2022, 37(1): 36-40.

ZHANG Xinyue, CHEN Liang, ZHENG Yu. Correlation between serum C peptide and insulin-like growth factor binding protein 3 and the risk of breast cancer patient death[J]. Laboratory Medicine, 2022, 37(1): 36-40.

图/表 5

参考文献 30

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组别	例数	年龄/岁	BMI/（kg/m²）		吸烟史/[例（%）]		饮酒史/[例（%）]	腰围/cm
死亡组	23	53.6±5.1	27.3±2.7		3（13）		4（17.4）	100.4±16.6
存活组	316	55.4±4.3	24.9±4.2		47（15）		59（18.6）	91.5±15.1
t值		-1.913	2.698		1.523		2.313	3.145
P值		0.06	0.007		0.077		0.369	0.0001
组别	C肽/（nmol/L）			FINS/（pmol/L）		FBG/（mmol/L）	SCr/（μmol/L）	IGFBP-3/（ng/mL）
死亡组	6.4±3.4			93.3±16.1		5.7±1.8	88.6±18.6	4 692.7±51.9
存活组	5.6±2.2			78.8±13.9		5.3±2.1	86.7±20.8	3 987.2±52.8
t值	2.198			1.572		3.154	3.421	2.921
P值	0.002			0.376		0.060	0.655	0.001

组别	例数	年龄/岁	BMI/（kg/m²）		吸烟史/[例（%）]		饮酒史/[例（%）]	腰围/cm
死亡组	23	53.6±5.1	27.3±2.7		3（13）		4（17.4）	100.4±16.6
存活组	316	55.4±4.3	24.9±4.2		47（15）		59（18.6）	91.5±15.1
t值		-1.913	2.698		1.523		2.313	3.145
P值		0.06	0.007		0.077		0.369	0.0001
组别	C肽/（nmol/L）			FINS/（pmol/L）		FBG/（mmol/L）	SCr/（μmol/L）	IGFBP-3/（ng/mL）
死亡组	6.4±3.4			93.3±16.1		5.7±1.8	88.6±18.6	4 692.7±51.9
存活组	5.6±2.2			78.8±13.9		5.3±2.1	86.7±20.8	3 987.2±52.8
t值	2.198			1.572		3.154	3.421	2.921
P值	0.002			0.376		0.060	0.655	0.001

项目	HR（95%CI）	P值
年龄	1.02（1.01~1.21）	0.003
BMI	1.03（1.01~1.13）	0.002
吸烟史	1.21（1.11~1.32）	0.001
饮酒史	1.08（1.03~1.17）	0.004
C肽	1.67（1.32~1.89）	0.007
FINS	1.05（1.02~1.22）	0.002
FBG	1.03（1.01~1.31）	0.004
腰围	1.01（0.98~1.29）	0.320
SCr	1.08（1.02~1.19）	0.030
IGFBP-3	1.91（1.23~3.17）	0.000 1

项目	HR（95%CI）	P值
年龄	1.02（1.01~1.21）	0.003
BMI	1.03（1.01~1.13）	0.002
吸烟史	1.21（1.11~1.32）	0.001
饮酒史	1.08（1.03~1.17）	0.004
C肽	1.67（1.32~1.89）	0.007
FINS	1.05（1.02~1.22）	0.002
FBG	1.03（1.01~1.31）	0.004
腰围	1.01（0.98~1.29）	0.320
SCr	1.08（1.02~1.19）	0.030
IGFBP-3	1.91（1.23~3.17）	0.000 1

组别	例数	IGFBP-3/（ng/mL）
C肽≤0.39 nmol/L组	84	4 190.72±39.21
C肽0.40~0.62 nmol/L组	85	4 235.46±33.46^*
C肽0.63~1.02 nmol/L组	85	4 418.23±30.54^**
C肽≥1.03 nmol/L组	85	4 529.16±43.12^**