糖类抗原15-3检测对乳腺癌骨转移的诊断价值

Determinant of carbohydrate antigen 15-3 for the diagnostic evaluation of bone metastasis of breast cancer

目的探讨糖类抗原15-3(CA15-3)在评价乳腺癌骨转移的价值。方法纳入在我院接受手术经病理学确诊的86例乳腺癌患者。采用99mTc-MDP核素骨显像检查并进一步病理学确认患者是否发生骨转移,记录发生骨转移的部位和数目。根据是否发生骨转移将患者分为2组。采用化学发光法检测所有患者血清CA15-3水平,比较2组患者CA15-3水平,分析CA15-3水平与骨转移累及部位数目的相关性;采用ROC曲线分析CA15-3水平对乳腺癌骨转移的诊断价值。结果乳腺癌骨转移组血清CA15-3水平高于无骨转移组(P<0.01)。骨转移累及部位数目与CA15-3水平的Spearman相关性分析结果显示两者并无相关性(r=-0.056,P=0.768)。ROC曲线分析结果显示CA15-3血清水平用于判断乳腺癌骨转移有显著意义(P=0.000)。当选CA15-3 24.675 U/mL为诊断界点,灵敏度为91.7%,特异度为93.8%。结论 CA15-3水平可以作为乳腺癌骨转移诊断的初步筛选指标。

Objective To explore the evaluation of carbohydrate antigen 15-3（CA15-3） for bone metastasis of breast cancer.Methods A total of 86 patients with definite histopathology diagnosis of breast cancer and bone metastasis certified by skeletal scinitigraphy and histopathology were included.Site of bone involvement area of bone and the number of area about bone involvement were recorded.According to whether the bone metastasis was existed,86 patients were divided into two groups.Serum levels of CA15-3 were measured by electrochemiluminescence.The correlation between the number of area about bone involvement and the serum levels of CA15-3 was assessed.ROC diagram were used to evaluate the diagnostic value of CA15-3 for bone metastasis of breast cancer.Results The average serum level of CA15-3 in the bone metastasis group was higher than that in the non-bone metastasis group（P〈0.01）.The correlation between the number of area about bone involvement and the serum levels of CA15-3 was not statistically significant（r=-0.056,P=0.768）.ROC diagram for anticipation of presence of bone metastasis of breast cancer,and it was demonstrated this variable was sufficient for this purpose（P=0.000）.When the cut-off point was 24.675 U/mL,the sensitivity and specificity were 91.7% and 93.8%,respectively.Conclusion The measurement of the serum levels of CA15-3 can be used as a preliminary screen to select patients of bone metastasis of breast cancer.