• 1.四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院乳腺外科(四川成都 610072);;
  • 2.遵義醫(yī)學(xué)院(貴州遵義 563003);

目的  探討血漿同型半胱氨酸(Hcy)水平與患乳腺癌風(fēng)險的相關(guān)性,擬對乳腺癌的預(yù)防、治療開辟新思路。
方法  本研究回顧性納入四川省人民醫(yī)院 2010 年 1 月至 2012 年 12月期間符合入組條件的乳腺癌患者245例(乳腺癌組)、良性乳腺腫瘤患者109例(良性乳腺腫瘤組)及體檢中心經(jīng)體檢者知情同意的健康女性78例作為對照(正常對照組)。比較各組血漿Hcy水平差異,并分析Hcy水平與年齡、血糖、血肌酐、雌激素受體(ER)、孕激素受體(PR)、Ki-67 (%)、腫瘤直徑及腋窩淋巴結(jié)狀況的關(guān)系。
結(jié)果  ①乳腺癌組、良性乳腺腫瘤組及正常對照組3組間的Hcy水平差異有統(tǒng)計學(xué)意義(P<0.001),其中乳腺癌組Hcy水平明顯高于乳腺良性腫瘤組(P<0.001)和正常對照組(P<0.001),而乳腺良性腫瘤組與正常對照組間比較差異無統(tǒng)計學(xué)意義(P=0.082)。②Luminal A型、Luminal B型、Her-2型及三陰型各型乳腺癌患者的Hcy水平均分別明顯高于乳腺良性腫瘤組(除外Her-2型,P<0.05)和正常對照組(P<0.05)。③354例良、惡性乳腺腫瘤患者血漿Hcy水平分別與年齡(r=0.197,P=0.004)及血肌酐水平(r=0.381,P<0.001)呈正相關(guān),而與血糖水平無相關(guān)(r=0.023,P=0.668)。④245例乳腺癌患者的Hcy水平分別與年齡(r=0.267,P=0.007)及血肌酐水平(r=0.341,P<0.001)呈正相關(guān),而與血糖(r=-0.005,P=0.935)、腫瘤直徑(r=-0.049,P=0.443)、淋巴結(jié)轉(zhuǎn)移數(shù)量(r=-0.006,P=0.921)及Ki-67 (rs=-0.029,P=0.650) 均無關(guān)。
結(jié)論  乳腺癌患者血漿Hcy水平有異常升高,其可能與乳腺癌的發(fā)生有一定聯(lián)系;降低血漿Hcy水平也許可降低乳腺癌風(fēng)險。

引用本文: 周志兵,周蕾蕾,羅靜,黃元坤,李學(xué)梅. 血漿同型半胱氨酸與乳腺癌關(guān)系的探討. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(8): 851-855. doi: 復(fù)制

1. Lin J, Lee IM, Song Y, et al. Plasma homocysteine and cysteine and risk of breast cancer in women[J]. Cancer Res, 2010, 70(6):2397-2405.
2. Chou YC, Lee MS, Wu MH, et al. Plasma homocysteine as a metabolic risk factor for breast cancer:findings from a case-control study in Taiwan[J]. Breast Cancer Res Treat, 2007, 101(2):199-205.
3. 鄧燕玲, 鄭利平. 血清同型半胱氨酸與乳腺癌發(fā)病的相關(guān)性分析[J]. 現(xiàn)代預(yù)防醫(yī)學(xué), 2012, 39(8):1921-1922.
4. Ferroni P, Palmirotta R, Martini F, et al. Determinants of homocysteine levels in colorectal and breast cancer patients[J]. Anticancer Res, 2009, 29(10):4131-4138.
5. 中國高血壓防治指南修訂委員會. 中國高血壓防治指南2010[J]. 中華心血管病雜志, 2011, 39(7):579-616.
6. Cakal B, Cakal E, Demirba? B, et al. Homocysteine and fibrin-ogen changes with L-thyroxine in subclinical hypothyroid patients[J]. J Korean Med Sci, 2007, 22(3):431-435.
7. Turhan S, Sezer S, Erden G, et al. Plasma homocysteine concen-trations and serum lipid profile as atherosclerotic risk factors in subclinical hypothyroidism[J]. Ann Saudi Med, 2008, 28(2):96-101.
8. Catargi B, Parrot-Roulaud F, Cochet C, et al. Homocysteine, hypothyroidism, and effect of thyroid hormone replacement[J]. Thyroid, 1999, 9(12):1163-1166.
9. Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypes-dealing with the diversity of breast cancer:highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J]. Ann Oncol, 2011, 22(8):1736-1747.
10. 劉君, 萬云高, 孫志媛, 等. 同型半胱氨酸與心腦血管病相關(guān)性研究進展[J/CD]. 中華臨床醫(yī)師雜志:電子版, 2012, 6(1):116-120.
11. De Caterina R, Zampolli A, Madonna R, et al. New cardiovas-cular risk factors:homocysteine and vitamins involved in homocy-steine metabolism[J]. Ital Heart J, 2004, 5 Suppl 6(6):19S-24S.
12. Williams KT, Schalinske KL. New insights into the regulation of methyl group and homocysteine metabolism[J]. J Nutr, 2007, 137(2):311-314.
13. Botto N, Andreassi MG, Manfredi S, et al. Genetic polymorphisms in folate and homocysteine metabolism as risk factors for DNA damage[J]. Eur J Hum Genet, 2003, 11(9):671-678.
14. Zecchina G, Ghio P, Bosio S, et al. Reactive thrombocytosismight contribute to chemotherapy-related thrombophilia in patientswith lung cancer[J]. Clin Lung Cancer, 2007, 8(4):264-267.
15. Perou CM, Sørlie T, Eisen MB, et al. Molecular portraits of human breast tumours [J]. Nature, 2000, 406(6797):747-752.
16. Feigelson HS, Jonas CR, Robertson AS, et al. Alcohol, folate, methionine, and risk of incident breast cancer in the American Cancer Society Cancer Prevention Study Ⅱ Nutrition Cohort[J]. Cancer Epidemiol Biomarkers Prev, 2003, 12(2):161-164.
17. Sellers TA, Grabrick DM, Vierkant RA, et al. Does folate intake decrease risk of postmenopausal breast cancer among women with a family history?[J]. Cancer Causes Control, 2004, 15(2):113-120.
18. Chen J, Gammon MD, Chan W, et al. One-carbon metabolism, MTHFR polymorphisms, and risk of breast cancer[J]. Cancer Res, 2005, 65(4):1606-1614.
19. Lajous M, Lazcano-Ponce E, Hernandez-Avila M, et al. Folate, vitamin B(6), and vitamin B(12) intake and the risk of breast canceramong Mexican women[J]. Cancer Epidemiol Biomarkers Prev,.
20. , 15(3):443-448.
  1. 1. Lin J, Lee IM, Song Y, et al. Plasma homocysteine and cysteine and risk of breast cancer in women[J]. Cancer Res, 2010, 70(6):2397-2405.
  2. 2. Chou YC, Lee MS, Wu MH, et al. Plasma homocysteine as a metabolic risk factor for breast cancer:findings from a case-control study in Taiwan[J]. Breast Cancer Res Treat, 2007, 101(2):199-205.
  3. 3. 鄧燕玲, 鄭利平. 血清同型半胱氨酸與乳腺癌發(fā)病的相關(guān)性分析[J]. 現(xiàn)代預(yù)防醫(yī)學(xué), 2012, 39(8):1921-1922.
  4. 4. Ferroni P, Palmirotta R, Martini F, et al. Determinants of homocysteine levels in colorectal and breast cancer patients[J]. Anticancer Res, 2009, 29(10):4131-4138.
  5. 5. 中國高血壓防治指南修訂委員會. 中國高血壓防治指南2010[J]. 中華心血管病雜志, 2011, 39(7):579-616.
  6. 6. Cakal B, Cakal E, Demirba? B, et al. Homocysteine and fibrin-ogen changes with L-thyroxine in subclinical hypothyroid patients[J]. J Korean Med Sci, 2007, 22(3):431-435.
  7. 7. Turhan S, Sezer S, Erden G, et al. Plasma homocysteine concen-trations and serum lipid profile as atherosclerotic risk factors in subclinical hypothyroidism[J]. Ann Saudi Med, 2008, 28(2):96-101.
  8. 8. Catargi B, Parrot-Roulaud F, Cochet C, et al. Homocysteine, hypothyroidism, and effect of thyroid hormone replacement[J]. Thyroid, 1999, 9(12):1163-1166.
  9. 9. Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypes-dealing with the diversity of breast cancer:highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J]. Ann Oncol, 2011, 22(8):1736-1747.
  10. 10. 劉君, 萬云高, 孫志媛, 等. 同型半胱氨酸與心腦血管病相關(guān)性研究進展[J/CD]. 中華臨床醫(yī)師雜志:電子版, 2012, 6(1):116-120.
  11. 11. De Caterina R, Zampolli A, Madonna R, et al. New cardiovas-cular risk factors:homocysteine and vitamins involved in homocy-steine metabolism[J]. Ital Heart J, 2004, 5 Suppl 6(6):19S-24S.
  12. 12. Williams KT, Schalinske KL. New insights into the regulation of methyl group and homocysteine metabolism[J]. J Nutr, 2007, 137(2):311-314.
  13. 13. Botto N, Andreassi MG, Manfredi S, et al. Genetic polymorphisms in folate and homocysteine metabolism as risk factors for DNA damage[J]. Eur J Hum Genet, 2003, 11(9):671-678.
  14. 14. Zecchina G, Ghio P, Bosio S, et al. Reactive thrombocytosismight contribute to chemotherapy-related thrombophilia in patientswith lung cancer[J]. Clin Lung Cancer, 2007, 8(4):264-267.
  15. 15. Perou CM, Sørlie T, Eisen MB, et al. Molecular portraits of human breast tumours [J]. Nature, 2000, 406(6797):747-752.
  16. 16. Feigelson HS, Jonas CR, Robertson AS, et al. Alcohol, folate, methionine, and risk of incident breast cancer in the American Cancer Society Cancer Prevention Study Ⅱ Nutrition Cohort[J]. Cancer Epidemiol Biomarkers Prev, 2003, 12(2):161-164.
  17. 17. Sellers TA, Grabrick DM, Vierkant RA, et al. Does folate intake decrease risk of postmenopausal breast cancer among women with a family history?[J]. Cancer Causes Control, 2004, 15(2):113-120.
  18. 18. Chen J, Gammon MD, Chan W, et al. One-carbon metabolism, MTHFR polymorphisms, and risk of breast cancer[J]. Cancer Res, 2005, 65(4):1606-1614.
  19. 19. Lajous M, Lazcano-Ponce E, Hernandez-Avila M, et al. Folate, vitamin B(6), and vitamin B(12) intake and the risk of breast canceramong Mexican women[J]. Cancer Epidemiol Biomarkers Prev,.
  20. 20. , 15(3):443-448.