CEA、CA15-3和CA125对乳腺癌的诊断价值以及影响因素探讨

The Diagnosis Value and Correlation Factors of Serum Tumor Markers CEA,CA15-3 and CA125 in Breast Carcinoma

研究肿瘤标志物CEA、CA15-3和CA125对乳腺癌的诊断价值,并对影响肿瘤标志物阳性率的相关因素进行分析。采用CLIA法测定血清CEA、CA15-3和CA125水平,以CEA>4.8μg/mL、CA15-3>25U/mL、CA125>35U/mL作为诊断阳性标准。乳腺癌组患者59例,乳腺良性组患者69例,对照组65名。结果表明:乳腺癌CEA,CA15-3和CA125水平较对照组和乳腺良性组明显升高(P<0.05)。CA15-3的灵敏度(42.4%)最高,CA125的特异度(89.6%)最高。采用平行联检法,可提高乳腺癌诊断的灵敏度(67.8%)和阴性预测值(85.0%)。而采用系列联检法,可提高特异度(91.0%)和阳性预测值(58.6%)。与乳腺癌肿瘤标志物阳性率显著相关的因素有:肿瘤分期、皮肤改变、淋巴转移、远处转移和P53(P<0.05)。

To explore the diagnosis value of serum tumor markers CEA, CA15-3 and CA125 in breast cancer, and analysis the correlation factors of positive rate of these markers. The serum samples from 59 patients with breast cancer,69 patients with benign breast disorders and 65 normal persons were collected. The serum levels of CEA, CA15-3 and CA125 in these samples were tested by chemiluminescence immunoassay. The levels of CEA 〉 4.8μg/mL, CA15-3 〉 25U/mL and CA125 〉 35U/mL in samples were used as the positive level. The results showed that the serum CEA, CA15-3 and CA125 levels in patients with breast cancer were significantly higher than those in patients with benign breast disorders and normal controls （P 〈0.05）. The CA15-3 showed the high- est sensitivity （42.4%） and the CA125 showed the highest specificity （89.6%）. The sensitivity （67.8%） and specificity （91.0%） of combined assay of CEA, CA15-3 and CA-125 could be enhanced. The results indicated that the correlation factor related to positive rate of tumor markers in patients with breast cancer may include the tumor stage, change of skin, lymph nodes metastasis, distant metastasis and P53 （ P 〈 0.05）.