【目的】探析血清微小核糖核酸-145 （miR-145） 、P53抗体在龙贝逍遥散治疗乳腺癌效果及预后评估中的检测价值。【方法】选取2020年1月～2021年1月北京航天总医院收治的90例乳腺癌患者作为研究对象，采用随机数字表法将患者随机分为观察组和对照组，每组各45例，2组患者均接受个性化综合治疗，观察组在此基础上联合龙贝逍遥散治疗，疗程为3个月。采用实时荧光定量 （PCR） 法检测血清miR-145表达水平，采用酶联免疫吸附法 （ELISA） 检测血清P53抗体表达水平。比较2组患者治疗前后的血清miR-145、P53抗体表达水平差异，采用Logistic回归分析法探析血清miR-145、P53抗体与观察组患者预后不良的关系，绘制受试者工作特征 （ROC） 曲线，分析血清miR-145、P53抗体在观察组预后不良预测中的应用价值。 【结果】（1） 治疗后，2组患者的血清miR-145检测值均呈上升趋势 （P＜0.05） ，P53抗体检测值均呈下降趋势 （P＜0.05） ，且观察组的血清miR-145检测值明显高于对照组，P53抗体检测值明显低于对照组，差异均有统计学意义 （P＜0.05） 。（2） 观察组预后良好组的血清miR-145检测值明显高于预后不良组，血清P53抗体检测值明显低于预后不良组，差异均有统计学意义 （P＜0.05） 。 （3） Logistic回归分析结果显示，miR-145高表达是观察组患者预后不良的保护因素，P53抗体高表达是观察组患者预后不良的危险因素 （P＜0.05） 。 （4） 血清miR-145、P53抗体联合预测观察组患者预后情况的曲线下面积 （AUC） 最大 （0.877，95%CI：0.769～0.985） ，其灵敏度、特异度分别为93.75%、93.10%，差异有统计学意义 （P＜0.05） 。 【结论】血清miR-145在乳腺癌预后不良中呈低表达，血清P53抗体在乳腺癌预后不良中呈高表达；龙贝逍遥散在乳腺癌患者中可达到较理想的治疗效果，有利于提升血清miR-145表达水平、降低血清P53抗体表达水平。

Objective To explore the value of serum microRNAs-145 （miR-145） and P53 antibody detection in the evaluation of therapeutic effect and prognosis in the treatment of breast cancer with Long Bei Xiaoyao Powder. Methods Ninety cases of breast cancer patients admitted to Beijing Aerospace General Hospital from January 2020 to January 2021 were selected as the study subjects. The patients were randomly divided into an observation group and a control group by random number table method，with 45 cases in each group. All of the patients in the two groups received individualized comprehensive treatment，and additionally the observation group was treated with Long Bei Xiaoyao Powder. The course of treatment covered three months. Real-time fluorescence quantitative polymerase chain reaction （PCR） method was used to detect serum miR-145 expression level，and enzyme-linked immunosorbent assay （ELISA） was used to detect serum P53 antibody expression level. The differences in the pre-and post-treatment expression levels of serum miR-145 and P53 antibodies in the two groups were compared，the relationship between the serum miR-145 and P53 antibody expression level and the poor prognosis of the patients in the observation group was explored by logistic regression analysis，and receiver operating characteristic curve （ROC） was drawn to analyze the value of the serum miR-145 and P53 antibody detection in the prediction of poor prognosis in the observation group. Results （1） After treatment，the detection value of serum miR-145 in the two groups of patients showed an increasing trend （P＜0.05），while that of the P53 antibody showed a decreasing trend （P＜0.05） . The intergroup comparison showed that the detection value of serum miR-145 in the observation group was significantly higher than that of the control group，while the detection value of P53 antibody was significantly lower than that of the control group，the differences being all statistically significant （P＜0.05） . （2）In the observation group，the detection value of serum miR-145 in the patients with good prognosis was significantly higher than that in the patients with poor prognosis，and the detection value of serum P53 antibody in the patients with good prognosis was significantly lower than that in the patients with poor prognosis， the differences being all statistically significant （P＜0.05） . （3） Logistic regression analysis showed that high expression of miR-145 was a protective factor for the patients with poor prognosis in the observation group， and high expression of P53 antibody was a risk factor for the patients with poor prognosis in the observation group （P＜0.05） . （4） The area under the ROC curve （AUC） for the prediction of prognosis of the patients in the observation group by the combination of serum miR-145 and P53 antibody was the largest （0.877，95%CI：0.769-0.985），and its sensitivity and specificity were 93.75% and 93.10%，respectively，with statistically significant differences（P＜0.05） . Conclusion Low expression of serum miR-145 and high expression of serum P53 antibody are presented in the breast cancer patients with poor prognosis and Powder exerts satisfactory therapeutic effectin treating breast cancer，which is conducive to enhancing the expression level of serum miR-145 and reducing the expression level of serum P53 antibody.

R273.379

国家自然科学基金资助项目 （编号：81603583）