ارﺗﺒﺎط ﺳﻄﺢ ﺳﺮﻣﯽ وﯾﺘﺎﻣﯿﻦ D ﺑﺎ ﺳﺮﻃﺎن ﭘﺴﺘﺎن و ﮔﯿﺮﻧﺪهﻫﺎي اﺳﺘﺮوژن و ﭘﺮوژﺳﺘﺮون، Her-2 در ﺷﻤﺎل اﯾﺮان

The Association between Serum Vitamin D Level with Breast Cancer and ER/PR, Her-2 in North of Iran

زﻣﯿﻨﻪ و ﻫﺪف: ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﯾﮑﯽ از ﺷﺎﯾﻌﺘﺮﯾﻦ ﺳﺮﻃﺎن ﻫﺎ در زﻧﺎن ﺳﺮاﺳﺮ دﻧﯿﺎ و اﯾﺮان اﺳﺖ. در ﺣـﺎل ﺣﺎﺿﺮ ﺑﯿﺶ از 40000 ﻧﻔﺮ در اﯾﺮان ﺑﻪ اﯾﻦ ﺑﯿﻤﺎري ﻣﺒﺘﻼ ﻫﺴﺘﻨﺪ. ﻣﻄﺎﻟﻌﺎت ﻧﺸﺎن ﻣﯽ دﻫﻨﺪ ﮐﻪ ﺷﮑﻞ ﻓﻌـﺎل وﯾﺘـﺎﻣﯿﻦD ﺑﻪ دﻟﯿﻞ اﻓﺰاﯾﺶ ﺗﻤـﺎﯾﺰ ﺳـﻠﻮﻟﯽ و ﻣﻬﺎر ﭘﺮوﻟﯿﻔﺮاﺳﯿﻮن ﻣﯽ ﺗﻮاﻧﺪ در ﺗﻐﯿﯿﺮ ﺧﻄﺮ ﺳﺮﻃﺎن ﻧﻘﺶ داﺷﺘﻪ ﺑﺎﺷﺪ. ﻣﻮاد و روش ﻫﺎ: ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ از ﻧﻮع ﺗﺤﻠﯿﻠﯽ و ﺑﻪ روش ﻣﻮرد - ﺷﺎﻫﺪي اﻧﺠﺎم ﺷﺪ. 150 ﺧﺎﻧﻢ ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﺑﻪ ﻋﻨﻮان ﮔﺮوه ﻣﻮرد و 150 ﺧﺎﻧﻢ ﻏﯿﺮﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن ﺑﻪ ﻋﻨﻮان ﮔﺮوه ﺷﺎﻫﺪ اﻧﺘﺨﺎب ﺷﺪﻧﺪ. ﻣﻌﯿﺎر ورود اﺛﺒﺎت وﺟﻮد ﺳﺮﻃﺎن ﭘﺴﺘﺎن در ﺑﯿﻤﺎران و رد آن در ﮔﺮوه ﺷﺎﻫﺪ ﺑﻮد. ﻧﺘﺎﯾﺞ ﺳﻄﺢ ﺳﺮﻣﯽ وﯾﺘﺎﻣﯿﻦ D، ﺑﻪ ﻫﻤﺮاه اﻃﻼﻋﺎت ﺳﻦ و وﺿﻌﯿﺖ ﺗﺄﻫﻞ در ﭼﮏ ﻟﯿﺴﺖ ﻣﻄﺎﻟﻌﻪ وارد ﺷﺪﻧﺪ. دادهﻫﺎي ﺑﻪ دﺳﺖ آﻣﺪه ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار آﻣﺎري SPSS ﻧﺴﺨﻪ 23 و آزﻣﻮنﻫﺎي آﻣﺎري ﻣﺮﺑﻊ ﮐﺎي، رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ و ﺗﯽ ﺗﺴﺖ دو ﻧﻤﻮﻧﻪاي ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ. در ﺗﻤﺎﻣﯽ آﻧﺎﻟﯿﺰﻫﺎي اﻧﺠﺎم ﺷﺪه ﺳﻄﺢ ﻣﻌﻨﯽداري ﮐﻤﺘﺮ از 0/05 در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ ﺳﻄﺢ وﯾﺘﺎﻣﯿﻦ D ﺳﺮم در ﮔﺮوه ﺑﯿﻤﺎران NG/ML 16/37±11/95 و در ﮔﺮوه ﺷﺎﻫﺪ NG/ML 27/04±18/49 و اﺧﺘﻼف ﺑﯿﻦ دو ﮔﺮوه ﻣﻌﻨﺎدار ﺑﻮد )0/001 < P(. ﺑﺮاﺳﺎس آﻧﺎﻟﯿﺰ رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ ﺑﺎ ﮐﺎﻫﺶ ﺳﻄﺢ ﺳﺮﻣﯽ وﯾﺘﺎﻣﯿﻦ D ﻧﺴﺒﺖ ﺷﺎﻧﺲ اﺑﺘﻼ ﺑﻪ ﺑﯿﻤﺎري اﻓﺰاﯾﺶ ﯾﺎﻓﺖ، ﺑﻄﻮري ﮐﻪ ﻧﺴﺒﺖ ﺷﺎﻧﺲ ﺑﯿﻤﺎري در ﻣﯿﺰان وﯾﺘﺎﻣﯿﻦ D ﺳﺮم NG/ML) 10 <( ﻧﺴﺒﺖ ﺑﻪ )NG/ML 10 -30( 1/93 ﺑﺮاﺑﺮ )0/954 ; 0/281:P = 0/035 ،%95 CI( و ﻧﺴﺒﺖ ﺑﻪ )NG/ML 30 >( 6/09 ﺑﺮاﺑﺮ )0/361 ;0/075 :P < 0/001 ،%95 CI( ﺑﻮد. ﻫﻤﭽﻨﯿﻦ ﺳﻄﺢ ﺳﺮﻣﯽ وﯾﺘﺎﻣﯿﻦ D ﺑﺎ ﮔﯿﺮﻧﺪه ﻫﺎي اﺳﺘﺮوژن و ﭘﺮوژﺳﺘﺮون ﺳﻠﻮل ﻫﺎي ﺳﺮﻃﺎﻧﯽ داراي ارﺗﺒﺎط ﻣﻌﻨﺎداري ﺑﻮد )0/001 < P( وﻟﯽ ﺑﺎ ﮔﯿﺮﻧﺪه HER-2 اﯾﻦ ارﺗﺒﺎط ﻣﻌﻨﺎدار ﻧﺒﻮد )0/195 = P(. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: ﺑﺮاﺳﺎس اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻄﻮر ﻣﻌﻨﺎداري ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎن ﭘﺴﺘﺎن داراي ﺳﻄﻮح ﭘﺎﯾﯿﻦ ﺗﺮي از وﯾﺘﺎﻣﯿﻦ D ﺳﺮﻣﯽ ﻧﺴﺒﺖ ﺑﻪ اﻓﺮاد ﺳﺎﻟﻢ ﺑﻮدﻧﺪ، ﺑﻨﺎﺑﺮاﯾﻦ ﮐﺎﻫﺶ ﻣﯿﺰان وﯾﺘﺎﻣﯿﻦ D ﺳﺮم ﺑﺎ اﻓﺰاﯾﺶ ﺧﻄﺮ اﺑﺘﻼ ﺑﻪ ﺑﯿﻤﺎري ﺳﺮﻃﺎن ﭘﺴﺘﺎن ارﺗﺒﺎط دارد و ﻣﯽﺗﻮاﻧﺪ ﯾﮑﯽ از ﻋﻮاﻣﻞ ﺧﻄﺮ اﺑﺘﻼ ﺑﻪ اﯾﻦ ﺑﯿﻤﺎري ﺑﺎﺷﺪ.

Introduction & Objective: Breast cancer is one of the most common cancers in women throughout the world including Iran. There are currently more than 40000 women in Iran suffering from the disease. Studies have shown that the active form of vitamin D, increases cell differentiation and inhibits proliferation, can play a role in changing the risk of breast cancer. Materials & Methods: Present study is analytical and case-control study. In this study150 women with breast cancer and150 women without breast cancer as control were investigated. Including criteria was diagnosis of breast cancer in all cases and absence breast cancer in all control group. Serum vitamin D level, age and marital data included in check list. The obtained data were subjected to chi square, logistic regression and two samples t-test by SPSS software version 23. In all analyses P ˂ 0.05 were as significant difference. Results: Mean level of serum vitamin D in case and control groups were 16.73 ± 11.95 and 27.04 ± 18.49 ng/ml, respectively ( P < 0.001). Based on multivariable analysis of logistic regression, the risk of developing breast cancer increased with a decrease in serum vitamin D levels. At the level of vitamin deficiency (10 > ng/ml), the odds ratio of illness were 1.93 times higher than the inadequate level. (%95 CI: 0.281; 0.954, P = 0.035), and the odds ratio of getting the disease were 6.9 times higher than the adequate level of vitamin D (%95 CI: 0.075; 0.361, P < 0.001). Also, the serum vitamin D level with estrogen receptors and progesterone receptors was significantly correlated (P < 0.001), but there was no significant correlation with HER-2 receptor (P = 0.195). Conclusions: Based on this study, patients with breast cancer had significantly lower levels of serum vitamin D in comparison with healthy women. Therefore, decreases in serum vitamin D levels are associated with an increased risk of breast cancer.