血清Tracp5b诊断乳腺癌骨转移及评价双膦酸盐治疗疗效的临床意义

Clinical value of serum Tracp5b as a marker to diagnose bone metastases in breast cancer patients and evaluate the therapeutic efficacy of bisphosphonate

目的:比较乳腺癌患者血清抗酒石酸酸性膦酸酶(Tracp5b)、糖类抗原-153(CA-153)及癌胚抗原(CEA)在诊断乳腺癌骨转移及评价双膦酸盐治疗效果中的临床意义。方法:采用酶联免疫吸附法(ELISA)及电化学发光法检测18名健康女性、26例无骨转移乳腺癌患者及32例乳腺癌骨转移患者的血清Tracp5b、CA-153及CEA水平;检测其中19例乳腺癌骨转移患者口服双膦酸盐骨膦(氯膦酸二钠)治疗3个月后血清Tracp5b、CA-153和CEA水平。结果:乳腺癌骨转移组血清Tracp5b的水平较无骨转移组及健康对照组明显升高,差异有统计学意义,P<0.05;血清Tracp5b诊断乳腺癌骨转移的敏感性为78.13%,特异性为86.36%;CA-153敏感性为37.50%,特异性为77.27%;CEA敏感性为21.88%,特异性为84.09%;Tracp5b的敏感性较CA-153、CEA高,差异有统计学意义,P<0.05。骨转移组19例患者经双膦酸盐治疗3个月后Tracp5b水平明显下降,差异有统计学意义(P<0.05),而CA-153及CEA下降不明显,差异无统计学意义,P>0.05。结论:Tracp5b在诊断乳腺癌骨转移中的敏感性较CA-153、CEA为高,可作为诊断乳腺癌骨转移和评价双膦酸盐治疗疗效血清标志之一。

OBJECTIVE： To compare the diagnostic value of serum tartrate-resistant acid phosphatase 5b（Tracp5b）, cancer antigen 153 （CA-153） and carcinoembryonic antigen （CEA） in patients with bone metastases of breast cancer, and study the clinical value in evaluating the therapeutic efficacy of bisphosphonate. METHODS： The serum levels of Tracp5b, CA 153 and CEA were determined by enzyme-linked immumosorbent assay and electrochemiluminescence in 26 breast cancer patients without bone metastases, 32 breast cancer patients with bone metastases and 18 healthy female adults. The serum levels of Tracp5b, CA-153 and CEA in 19 breast cancer patients with bone metastases after 3 months of bisphosphonate treatment were also detected. RESULTS： The serum levels of Tracp5b in breast cancer patients with bone metastases were significantly higher than those in the other two groups, P〈0.05. The sensitivity of TracpSb to bone metastases was 78. 13% with specificity of 86. 36%. The sensitivity and specificity of CA-153 to bone metastases were 37.50% and 77.27%, and those of CEA were 21.88% and 84.09%, respectively. The sensitivity of Tracp5b was significantly higher than those of CA-153 and CEA, P%0.05. The serum levels of Tracp5b decreased significantly after 3 months of bisphosphonate treatment, while CA 153 and CEA decreased slightly, P〉0.05. CONCLUSIONS： Tracp5b has a higher sensitivity than CA-153 and CEA to diagnose bone metastases in breast cancer patients. Tracp 5b is a useful marker to diagnose bone metastases in breast cancer patients and evaluate the therapeutic efficacy of bisphosphonate.