Clinical study of serum Dickkopf-related protein 1 and chemokine ligand 13 in predicting recurrence of breast cancer patients after modified radical mastectomy
10.3760/cma.j.cn115455-20240612-00497
- VernacularTitle:血清Dickkopf相关蛋白1、趋化因子配体13预测乳腺癌患者改良根治术后复发的临床研究
- Author:
Yong YAN
1
;
Yao WANG
;
Fang DONG
Author Information
1. 济宁医学院附属医院乳腺外科，济宁 272000
- Publication Type:Journal Article
- Keywords:
Breast neoplasms;
Recurrence;
Modified radical mastectomy;
Dickkopf-related protein 1;
Chemokine ligand 13
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(4):304-310
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of serum Dickkopf-related protein 1 (DKK1) and chemokine ligand 13 (CXCL13) in the recurrence of breast cancer after modified radical mastectomy.Methods:The data of 92 patients with breast cancer who underwent modified radical mastectomy in the Affiliated Hospital of Jining Medical University from January 2020 to January 2021 were retrospectively collected. The clinical data and follow-up data of the patients were inquired, and the patients were divided into recurrence group (9 cases) and non-recurrence group (83 cases) according to the recurrence in the 3-year follow-up data. The clinical data and serum DKK1 and CXCL13 levels before and 1-day after operation were compared between the two groups. COX regression model was used to analyze the relationship between serum DKK1, CXCL13 and recurrence. The interaction of serum DKK1 and CXCL13 on recurrence was analyzed by interaction. The receiver operating characteristic (ROC) curve was drawn and the decision curve was constructed to further analyze the predictive value of serum DKK1 and CXCL13 on recurrence.Results:The preoperative serum carbohydrate antigen 125, the proportion of patients with poorly differentiated tumor, the proportion of patients with TNM stage Ⅲ, the serum DKK1 and CXCL13 before and 1-day after operation in the recurrence group were higher than those in the non-recurrence group: (41.12 ± 5.38) kU/L vs. (34.67 ± 6.69) kU/L, 5/9 vs. 12.05% (10/83), 6/9 vs. 16.87% (14/83), (4.89 ± 0.78) μg/L vs. (3.54 ± 0.67) μg/L, (187.02 ± 25.04) ng/L vs. (154.37 ± 28.10) ng/L, (3.73 ± 0.33) μg/L vs. (3.46 ± 0.35) ng/L, there were statistical differences( P<0.05). COX regression analysis showed that recurrence of breast cancer patients after modified radical mastectomy were related to preoperative serum DKK1 and CXCL13, and the high expression of both might be a risk factor for postoperative recurrence ( P<0.05). The expression of DKK1 and CXCL13 in serum before operation had a positive interaction on the recurrence. When they were both highly expressed, the risk of recurrence after operation was 9.600 times that of both low expression, and the synergistic effect was38.656 times that of the sum of the effects of both alone.The ROC curve showed that the area under the curveof preoperative serum DKK1 and CXCL13 alone and jointly to predict the recurrence were 0.906, 0.823 and 0.964, respectively, which had ideal predictive value. The decision curve showed that when the threshold was 0.07 to 0.20 and 0.4 to 1.0, the net return rate of combined prediction of preoperative serum DKK1 and CXCL13 for the recurrence risk of breast cancer patients after modified radical mastectomywas higher, and the maximum net return rate was 0.098. Conclusions:The recurrence of breast cancer patients after modified radical mastectomy may be related to the abnormal levels of serum DKK1 and CXCL13 before surgery. The higher the preoperative serum DKK1 and CXCL13 levels, the higher the risk of recurrence after surgery. Combined detection of serum DKK1 and CXCL13 before surgery in breast cancer patients can effectively predict the risk of recurrence after surgery.
