Clinical Study On The Serum Levels Of Lactate Dehydrogenase And Sialic Acid Of Phyllodes Tumors Of The Breast

Purpose:This study mainly researches the relationship between the serum levels of LDH and SA and clinicopathological characteristics in phyllodes tumors(PTs)of the breast patients,in an attempt to discuss their clinical application value in the diagnosis and treatment of the patients with phyllodes tumors of the breast.Materials and Methods:From December 1,2008 to December 31,2020,214 patients with phyllodes tumors of the breast were collected from Qilu hospital of Shandong university.These included 156 cases of benign PTs,36 cases of borderline PTs and 22 cases of malignant PTs.At the same time,981 cases of the breast fibroadenoma patients were collected as a control group.We collected the serum levels of LDH and SA and the complete clinicopathological characteristics of each patient before surgery to analyze the relationship between them.Then,we analyzed the independent influencing factors related to the serum levels of LDH and SA by multivariate analysis.Results:1.There were statistically differences in LDH levels between fibroadenoma and PTs,fibroadenoma and borderline PTs,fibroadenoma and borderline and malignant PTs(p=0.0021,p=0.0129,p=0.0020).We evaluated the diagnostic performance of LDH levels in fibroadenoma and phyllodes tumors by ROC curve.The cut off value of LDH was 165.5U/L.Then,we analyzed the relationship between the serum levels of LDH and the clinicopathological characteristics by whether LDH greater than or equal to 166U/L.There were statistically differences in LDH levels in age,BMI and mass size(p<0.0001,p<0.0001,p=0.0099).We analyzed the independent influencing factors related to the LDH levels by multivariate analysis based on the results of the univariate analyses.The results of multivariate analysis showed that age,BMI and mass size were the independent factors affecting the LDH levels(p=0.045,p<0.001,p=0.004).That meaned patients with age greater than or equal to 40 years,BMI greater than or equal to 24kg/m2,and tumor size greater than or equal to 3 cm were more likely to show increased LDH levels.The risk of increased LDH levels in patients with age≥40 years was 1.299 times higher than that in patients with age<40 years.The risk of increased LDH levels in patients with BMI≥24kg/m2 was 1.785 times higher than that in patients with BMI<24kg/m2,and the risk of increased LDH levels in patients with mass size≥3cm was 1.478 times higher than that in patients with mass size<3cm.2.There were statistically differences in SA levels between fibroadenoma and PTs,fibroadenoma and begin PTs(p=0.0123,p=0.0172).We evaluated the diagnostic performance of SA levels in fibroadenoma and phyllodes tumors by ROC curve.The cut off value of SA was 56.65mg/dL.Then,we analyzed the relationship between the serum levels of LDH and the clinicopathological characteristics by whether SA greater than or equal to 56.7mg/dL.There were statistically differences in SA levels in age,BMI and childbearing history(p<0.0001,p<0.0001,p=0.0086).We analyzed the independent influencing factors related to the SA levels by multivariate analysis based on the results of the univariate analyses.The results of multivariate analysis showed that agw,BMI and childbearing history were the independent factors affecting the LDH levels(p=0.004,p<0.001,p=0.005).That meaned patients with age greater than or equal to 40 years,BMI greater than or equal to 24kg/m2 and patients without childbearing history were more likely to show increased SA levels.The risk of increased SA levels in patients with age≥40 years was 1.515 times higher than that in patients with age<40 years,and the risk of increased SA levels in patients with BMI>24kg/m2 was 2.714 times higher than that in patients with BMI<24 kg/m2.Increased SA levels were 0.672 times higher in patients with childbearing history than without.Conclusions:1.The univariate analyses show that serum LDH levels were higher in patients with PTs than in patients with fibroadenoma,in which serum LDH levels were increased in borderline PTs,borderline and malignant PTs.Meanwhile,patients with age greater than or equal to 40years,BMI greater than or equal to 24kg/m2 and tumor size greater than or equal to 3cm are more likely to show increased LDH levels.2.The univariate analyses show that serum SA levels were higher in patients with PTs than in patients with fibroadenoma,in which serum SA levels were increased in benign PTs.Meanwhile,patients with age greater than or equal to 40years,BMI greater than or equal to 24kg/m2 and and patients without childbearing history are more likely to show increased SA levels.3.Multivariate analysis show that age,BMI and mass size are the independent factors affecting the LDH levels.That means patients with age greater than or equal to 40years,BMI greater than or equal to 24kg/m2 and tumor size greater than or equal to 3cm are more likely to show increased LDH levels.4.Multivariate analysis show that age,BMI and childbearing history are the independent factors affecting the SA levels.That means patients with age greater than or equal to 40years,BMI greater than or equal to 24kg/m2 and patients without childbearing history more likely to show increased SA levels.