CAl53，B—AKP与BSP在诊断乳腺癌骨转移的临床价值

Clinical Value of Detecting CA153,B-AKP and BSP in Diagnosis of Bone Metastasis for Breast Cancer

目的评价CAl53、骨性碱性磷酸酶（bonealkalinephosphatase，B-AKP）、骨涎蛋白（bonesialoprotein，BSP）联合检测在诊断乳腺癌骨转移的临床价值。方法随机选取2009年1月～2012年4月行放射性核素显像的乳腺癌患者94例为实验组（病理学确诊为乳腺癌的病人），健康体检者30例为对照组（所有检查均正常的体检者），分别检测外周血清中CAl53，BSP和KAKP的含量。结果实验组患者血清中CAl53，BSP和B_AKP明显高于对照组（t=7．99，5．52，3．93；P〈0．001）；放射性核显像（ECT）显示发生骨转移51例，显像正常无骨转移43例；无骨转移组CAl53，B．AKP和BSP的含量均高于对照组，但差异无统计学意义（t=1．42，1．51，1．41；P=0．16，0．14，0．16）；发生骨转移组CAl53，13-AKP和BSP的含量明显高于对照组（t=11．62，7．85，11．4；P〈0．001）；≤2个骨转移灶患者的CAl53，BSP，B-AKP水平明显低于〉2个骨转移灶患者（t=3．51，2．71，2．39；P=0．001，0．01，0．02）。结论血清中CAl53，BSP和睁AKP水平的检测联合全身骨显像可以提高乳腺癌骨转移的检出率。

Objective To evaluation the clinical value with serum levels of CA153,BSP and B-AKP in breast cancer of bone metastases. Methods Selected randomly the row of radionuclide imaging of 94 patients with breast cancer for the experi- mental group, the healthy check-up 30 cases as control group and measured the level of serum CA153,BSP and B-AKP. Re- sults Serum CA153, BSP and B-AKP levels in experimental group were significantly higher than those in controls （t= 7.99,5.52,3.93, P〈0. 001）. ECT showed bone metastasis 51 cases, normal imaging 43 cases. The serum tumor marker lev- els in patients without osseous metastasis were only insignificantly higher than those in controls （t=1.42,1.51,1.41, P= 0.16,0.14,0.16）. The serum levels of CA153, BSP and B-AKP in patients osseous metastasis were significantly higher than those in controls （t=ll. 62,7.85,11.4,P〈0. 001）. The levels in patients with only one or two bone lesions were signifi- cantly lower than those in patients with more than 2 bone lesions （t=3. 51,2. 71,2. 39 ,P=0. 001,0.0i ,0.02）. Conclusion Combined detection of CA153, BSP,B-AKP and whole body bone scan could increase detection rate.