联合诊断法诊断早期乳腺癌的临床应用价值

The clinical value of combined diagnosis in the diagnosis of early breast cancer

目的探讨血清肿瘤标志物癌抗原15-3（CA15-3）、细胞角蛋白19片段抗原（CYFRA21-1）联合彩色多普勒超声及钼靶X线对早期乳腺癌诊断的临床应用价值。方法选取106例乳腺癌患者（乳腺癌组）和50例乳腺良性病变患者（对照组），将患者血清CA15-3、CYFRA21-1、彩色多普勒超声和钼靶X线检查资料与手术后病理对照，进行回顾性分析。结果CA15-3对早期乳腺癌诊断的敏感度为63．2％（67／106），特异度为94．0％（47／50）；CYFRA21-1敏感度为73．6％（78／106），特异度为88．0％（44／50）；彩色多普勒超声敏感度为77．4％（82／106），特异度为90．0％（45／50）；钼靶X线敏感度为75．5％（80／106），特异度为92．0％（46／50）。四项联合检查敏感度高达96．2％（102／106），特异度为80．0％（40／50），敏感度与各单项检查相比差异有统计学意义（P〈0．05）。结论应用联合诊断法诊断早期乳腺癌是发现乳腺癌的有效途径，具有较高的阳性检出率和可靠的临床指导意义。

Objective To investigate the clinical value of serum tumor makers CA15-3, 19 fragments of cellular keratin antigen （CYFRA21-1） combined with the color Doppler ultrasound and mammography X-ray in diagnosis of early breast cancer. Methods According to the postoperative pathologic diagnosis, collected 106 cases of patients with breast cancer （breast cancer group） and 50 cases of patients with benign breast lesions （control group）, the serum tumor makers CA15-3,CYFRA21-1, the color Doppler ultrasound and mammography X-ray were compared with postoperative pathology and statistical analyzed retrospectively. Results The sensitivity of CA15-3 was 63.2% （67/106）, specificity was 94.0% （ 47/50 ） ; the sensitivity of CYFRA21-1 was 73.6% （ 78/106 ）, specificity was 88.0% （44/50） ; the sensitivity of color Doppler ultrasound was 77.4% （82/106）, specificity was 90.0%（45/50） ; the sensitivity of mammography X-ray was 75.5% （80/106）, specificity was 92.0% （46/50）;the sensitivity of the four combined detections was 96.2%（102/106）, specificity was 80.0%（40/50）. The sensitivity of combined detection was higher than any of them individually, there was statistical significance （P 〈 0.05）. Conclusions Combined diagnosis is an effective way of early breast cancer detection. It has high positive rate of diagnosis and reliable guidance significance for diagnosis and treatment.