多种相关肿瘤标志物联合检测诊断乳腺癌复发的意义

Exploring the clinical value of combined tumor markers detection in diagnostics of breast cancer recurrence

目的探讨血清胸苷激酶1（TK1）、糖类抗原15—3（CA15—3）和癌胚抗原（CVa）联合检测诊断乳腺癌复发的意义。方法应用免疫印迹-增强化学发光法对乳腺癌未复发组患者（413例）和乳腺癌复发组患者（49例）的血清TK1进行检测，应用电化学发光法对血清CA15—3和CEA进行检测。结果乳癌术后未复发患者血清TK1、CA15—3和CEA的表达水平分别为1．40±1．25pmol／L、17．18±50．91U／ml和2．50±7．15ng/ml，术后复发组为2．46±2．35pmol/L、49．50±85．26u／nd和17．59±66．66ng／ml，两组患者血清，n（1、CA15—3和CEA的表达水平比较差异均具有统计学意义（P〈0．01）；血清TK1、CA15—3和CEA以及3者联合检测在乳腺癌术后复发组的敏感度、特异度及准确度分别是TK1为48．98％、83．78％及80．09％，CA15—3为28．57％、96．85％及88．10％，CEA为16．33％、96．61％及89．61％；3者联合为73．47％、78．93％及78．35％。结论血清TK1、CA15—3和CEA在乳癌术后复发患者中的表达明显高于未复发患者，可用于乳癌患者术后复发的诊断、疗效评估及病情监测，3种标志物联合检测能提高诊断乳腺癌复发的敏感度。

Objective To study the clinical value of serum markers：Thymidine kinase 1 （TK1）, Carbohydrate antigen 15 - 3（CA15 - 3）and Careineembryonle antigen（CEA）in diagnosis of recurrent breast cancer. Methods 413 patients with no recurrence of breast cancer and 49 patients with recurrent breast cancer were among this study.The levels of serum TK1 were detected by enhanced chemilumilfiseence dotblot assay, ttle levels of serum CA15 - 3, CEA were detected by immunoassay. The data results from experiment were statistically analyzed. Results The levels of TK1, CA15 - 3 and CEA in patients with no recurrence of breast cancer were 1.40 ± 1.25 pmol/L, 17.18 ± 50.9 1U/ml,2.50 ± 7.15 ng/ml compared with the markers level of recurrent breast cancer patients group： 2.46 ± 2.35 pmol/L, 49.50±85.26 U/ml, 17.59±66.66 ng/ml. The results indicated that the levels of TKI, CA15 - 3and CEA had a significant differences between two groups（ P 〈 0.01）. The sensitivity, specificity and accuracy of Serum TK1, CA15 - 3, CEA in group of recurrent breast cancer were Separately shown： TKI： 48.98% ,83.78% ,80.09% ; CA15 - 3：28.57% ,96.85%, 88.10% ; CEA： 16.33%, 96.61%, 89.61% ; Combined detection： 73.47% ,78.93% ,78.35% .Conclusion Serum TK1, CEA, CA15 - 3; combined detection can be used for diagnosis, effieacy assessment and monitoring of disease recurrence in breast cancer patients, since the expression of serum TK1, CA15 - 3, CEA in patients with breast cancer recurrence was signifieandy higher than the compared group. This detection technique dlstincdy improves the sensitivity in diagnosis of recurrent breast cancer.