乳腺癌患者外周血中颗粒酶B和穿孔素的表达及意义

doi:10.3969/j.issn.1006-5725.2023.22.003

Abstract

Abstract:

Objective To analyze the diagnostic value of the expression of Granzyme B and Perforin in peripheral blood T lymphocytes and NK cells in patients with breast cancer （BC）， to investigate the correlation between the expression of granzyme B and perforin and the clinicopathological characteristics of BC， including molecular typing and tumor stage， and the evaluation of the therapeutic effect on BC. Methods Flow cytometry was used to detect the expression of granzyme B and perforin in CD3⁺T cells， CD8⁺T cells and NK cells in 108 patients with BC and 70 benign breast disease controls， and to evaluate the diagnostic efficiency of the receiver operating characteristic （ROC） curve of each indicator in BC； to compare the expression of granzyme B and perforin in patients with different clinicopathological characteristics and the changes of various indicators before and after treatment. Results The expressions of granzyme B and perforin in T lymphocyte subsets and NK cells in BC patients were significantly higher than those of the control group （P < 0.05）. ROC analysis showed that the area under the curve （AUC） of granzyme B and perforin positive rates in CD3⁺T cells， CD8⁺T cells and NK cells was greater than 0.5. The expression of granzyme B and perforin in CD3⁺T cells was positively correlated with the tumor size and clinical stage of BC （P < 0.05）， and granzyme B in CD8⁺T cells was also positively correlated with the tumor size and clinical stage of BC （P < 0.05）. The expression of granzyme B and perforin in CD3⁺T cells in BC patients with lymph node metastasis was significantly greater than that in BC patients without lymph node metastasis （P < 0.05）. The expression of granzyme B and perforin in peripheral blood T lymphocytes in BC patients after treatment was greater than that before treatment （P < 0.05）. Conclusion The expression of granzyme B and perforin in CD3⁺T cells， CD8⁺T cells and NK cells in peripheral blood has certain reference for the diagnosis of BC， and has correlation with tumor size， lymph node metastasis and clinical stage， which can assist in the early screening， diagnosis and treatment evaluation of BC.

Key words: breast cancer, T lymphocytes, NK cells, granzyme B, perforin, molecular typing

CLC Number:

R730.45

Zhaowei ZHUANG,Wumei YUAN,Zuodong REN,Shangfei LI,Minggui CHEN,Yan. ZENG. Expression and significance of granzyme B and perforin in peripheral blood of patients with breast cancer[J]. The Journal of Practical Medicine, 2023, 39(22): 2872-2877.

Figures/Tables 5

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Tab.1

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References 20

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指标	临界值（%）	敏感度（%）	特异度（%）	AUC	95%CI	P值
CD3⁺细胞颗粒酶B阳性率	22.380	77.8	61.4	0.729	0.655 ~ 0.803	< 0.001
CD8⁺细胞颗粒酶B阳性率	44.465	71.3	77.1	0.778	0.707 ~ 0.849	< 0.001
NK细胞颗粒酶B阳性率	91.075	54.6	57.1	0.611	0.528 ~ 0.695	0.012
CD3⁺细胞穿孔素阳性率	29.045	66.7	67.1	0.698	0.622 ~ 0.774	< 0.001
CD8⁺细胞穿孔素阳性率	53.670	58.3	84.3	0.754	0.684 ~ 0.825	< 0.001
NK细胞穿孔素阳性率	92.795	67.6	52.9	0.602	0.517 ~ 0.686	0.022

变量		例数	颗粒酶B阳性率（%）			穿孔素阳性率（%）
变量		例数	CD3⁺细胞	CD8⁺细胞	NK细胞	CD3⁺细胞	CD8⁺细胞	NK细胞
HER?2	阴性	42	31.99	54.01	91.58	34.21	53.51	93.62
	阳性	41	30.63	52.57	93.63	35.39	54.93	94.56
Z值			-1.011	-0.829	-0.009	-0.132	-0.328	-0.159
P值			0.312	0.407	0.993	0.895	0.743	0.873
ER	阴性	31	26.46	52.54	93.06	32.88	54.24	94.56
	阳性	52	33.63	53.76	92.00	35.86	54.55	93.62
Z值			-1.092	-0.297	-0.551	-1.045	-0.094	-1.497
P值			0.275	0.767	0.582	0.296	0.925	0.134
PR	阴性	43	28.32	53.41	93.76	33.65	54.80	95.05
	阳性	40	34.59	53.31	91.58	35.55	53.88	93.22
Z值			-0.857	-0.014	-0.333	-0.766	-0.456	-1.221
P值			0.392	0.989	0.739	0.444	0.649	0.222
Ki?67	低表达	20	34.19	55.12	93.09	34.40	54.87	94.59
	高表达	63	29.38	52.28	92.84	34.64	54.34	93.28
Z值			-0.655	-0.905	-0.426	-0.282	-0.788	-0.453
P值			0.513	0.365	0.670	0.778	0.431	0.651
肿瘤大小	≤ 2 cm	33	24.90	48.46	93.86	30.24	54.36	95.58
	2 ~ 5 cm	45	35.89	55.38	92.32	36.51	54.93	93.82
	> 5 cm	5	35.28	57.98	86.88	39.54	51.20	87.10
H值			11.583	6.598	4.701	7.558	2.105	7.558
P值			0.003	0.037	0.095	0.023	0.349	0.133
淋巴结转移	否	38	26.24	50.21	93.79	33.21	54.87	95.37
淋巴结转移	是	45	35.89	55.38	91.60	36.94	54.34	93.79
Z值			-2.646	-1.659	-0.713	-2.322	-0.484	-1.531
P值			0.008	0.097	0.476	0.020	0.628	0.126
TNM分期	Ⅰ	23	23.29	48.46	93.82	30.05	55.85	94.56
	Ⅱ	39	34.03	52.57	93.63	34.64	54.02	95.05
	Ⅲ-Ⅳ	21	35.70	59.31	91.43	36.51	54.80	92.86
H值			7.223	6.321	0.862	6.819	1.769	2.818
P值			0.027	0.042	0.650	0.033	0.413	0.244
分子分型	Luminal A型	9	37.36	56.57	91.01	38.87	50.97	87.10
	Luminal B型	34	30.24	49.38	90.48	34.55	54.65	92.94
	HER?2型	28	27.42	53.92	93.81	35.33	54.87	95.10
	三阴型	12	28.81	55.28	94.20	32.29	54.94	96.55
H值			3.622	3.356	3.085	3.318	2.333	4.880
P值			0.305	0.340	0.379	0.345	0.506	0.181

项目	例数	颗粒酶B阳性率（%）			穿孔素阳性率（%）
项目	例数	CD3⁺细胞	CD8⁺细胞	NK细胞	CD3⁺细胞	CD8⁺细胞	NK细胞
治疗前	22	25.10	42.05	91.25	24.45	46.06	94.10
治疗后	102	32.14	54.98	91.26	35.36	56.22	93.44
Z值		-2.580	-3.411	-0.448	-2.996	-2.744	-0.739
P值		0.010	0.001	0.654	0.003	0.006	0.460

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Expression and significance of granzyme B and perforin in peripheral blood of patients with breast cancer

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