The Expression And Clinical Significance Of Serum Adiponectin And Vascular Endothelial Growth Factor In Breast Cancer

objectives:1.Detecting serum adiponectin and vascular endothelial growth factor?VEGF?levels in women with breast cancer,benign breast disease and healthy women,to find differences in the expression of serum adiponectin and VEGF in breast cancer patients,benign breast disease,and healthy women.2.To investigate the relationship between serum adiponectin and VEGF expression in breast cancer patients.3.Analyze the expression of serum adiponectin and VEGF in different clinical pathological parameters of breast cancer.4.Analysis of serum adiponectin and VEGF expression differences in different body mass index and menstrual state.5.Study on the detection significance of serum adiponectin combined with VEGF in breast cancer.Methods:According to inclusion criteria and exclusion criteria,100women with breast masses hospitalized in the breast department of Mianyang Central Hospital from August 2016 to August 2017 were selected.All subjects underwent thoracic needle biopsy or surgery for breast tumors in this hospital.The test confirmed the diagnosis,including 50 cases of breast cancer patients and 50 cases of benign diseases.At the same time,50 healthy women from the hospital's physical examination center were randomly selected.The fasting serum of patients with breast cancer,benign disease and healthy woman were collected.The enzyme-linked immunosorbent assay?ELISA?was used to determine the adiponectin and VEGF in serum of each group.Recording subject data included age,body mass index?BMI?,menopause,the breast cancer data also included mass size,pathological stage,histological grade,molecular typing,ipsilateral axillary lymph node metastasis,estrogen receptor?ER?,progesterone receptor?PR?,human epidermal growth factor receptor-2?Her-2?,cell proliferation factor?Ki-67?.Statistical analysis was performed using IBM SPSS 24.0 statistical software.P<0.05 was statistically significant.Result:1.Analyze the difference of age,BIM in breast cancer group,benign disease group and healthy group,and the difference of serum adiponectin and VEGF expression in three groups:?1?The average BMI and age of the breast cancer were greater than those of the healthy and benign diseases group,the difference was statistically significant?p<0.05?,but the difference between benign disease group and healthy group was not statistically significant?p>0.05?.?2?The serum adiponectin level in the breast cancer group was lower than that in the benign disease group.The serum adiponectin expression was lower in the breast cancer group and the benign disease group than in the healthy group,but the difference was not statistically significant?P>0.05?;The serum VEGF level in the preoperative breast cancer group was higher than that in the benign disease group,and the serum levels of the two groups were higher than those in the healthy group?p<0.05?.2.Analysis of serum adiponectin and VEGF levels in breast cancer patients with different pathological parameters:?1?Different pathological stages of breast cancer,histological grade,axillary lymph node metastasis and different sizes of tumors made the difference in serum adiponectin and VEGF expression statistically significant?p<0.05?:the later the pathological staging of breast cancer patients and the histological grade,the larger the tumor size and the more lymph node metastasis,the lower the expression of serum adiponectin.On the contrary,the higher the serum VEGF expression.?2?Positive expression of ER,PR and Her-2,the high or low expression of Ki67 did not affect the expression of serum adiponectin and VEGF in breast cancer patients?P>0.05?.?3?There was no difference in the expression of adiponectin and VEGF in breast cancer under different molecular typing?p>0.05?.3.The analysis of serum adiponectin and VEGF expression in three groups under different BMI and menstrual status:?1?The difference in serum adiponectin levels between premenopausal and postmenopausal women with breast cancer was statistically significant?p<0.05?,but there was no difference in VEGF?p>0.05?.There was no difference in pre-and post-menopausal serum adiponectin and VEGF in the benign disease group and the healthy group?p>0.05?.?2?In the breast cancer group,benign disease group and healthy group,the serum adiponectin level of BMI<24kg/m² was lower than that of BMI?24kg/m²;the serum VEGF level was higher than those with BMI?24kg/m².However,the difference was not statistically significant?p>0.05?.Whether or not the BMI was greater than 24 kg/m²,there was no difference in serum adiponectin expression between the healthy group and the benign disease group.There was no difference in serum VEGF levels between the benign disease group and the breast cancer group?p>0.05?.?3?Serum adiponectin levels in premenopausal and postmenopausal women with breast cancer were lower than those in benign disease group,and both of them were lower than those in healthy subjects.The premenopausal serum adiponectin levels in the three groups were statistically significant?p<0.05?.There was no significant difference in the postmenopausal serum adiponectin levels between benign disease group and the healthy group?p>0.05?.?4?The levels of serum VEGF in premenopausal women with benign disease were higher than those in women with breast cancer,both of two were higher than those in healthy women?p<0.05?,but there was no significant difference in benign disease group and breast cancer group?p>0.05?.The serum VEGF level in postmenopausal breast cancer group was higher than that in benign disease group,both of two were higher than that in healthy group?p<0.05?,but there was no significant difference between benign disease group and breast cancer group?p>0.05?.4.There was a negative correlation between serum adiponectin and levels of vascular endothelial growth factor in patients with breast cancer,R=-0.33,P<0.01.The ROC curve of subjects analyzed the diagnostic performance of the adiponectin and VEGF for breast cancer which includes sensitivity,specificity and area under the ROC curve?the area under the curve,AUC?.Adiponectin related diagnostic performance index was 89%,86%,0.942,and the VEGF was 96%,59%,0.832,respectively.The combined detection of the two was higher than the detection of adiponectin or VEGF respectively:AUC _{adiponectin+VEGF}=0.996>AUC _adiponectin=0.942>AUC_VEGF=0.832.Conclusion:1.Serum adiponectin combined with detection of VEGF may be an adjunct to the monitoring of women's breast disease progression,especially in women with high-risk breast cancer,such as obesity and postmenopausal women.2.Serum adiponectin and VEGF were related to the pathological stage,tumor pathological grade,lymph node metastasis,and tumor size of breast cancer patients.Different ER,PR,HER-2,Ki67 expression and different molecular typing did not affect serum adiponectin and VEGF levels.3.Serum adiponectin was negatively correlated with VEGF in breast cancer.Adiponectin has good sensitivity and specificity for the diagnosis of breast cancer.VEGF has good sensitivity but its specificity is not strong;combined serum adiponectin and VEGF can determine the progress of breast disease to some extent.