乳腺癌外周血乳腺上皮小黏蛋白和CA153联合检测的临床价值

Clinical value of the combined detection of SBEM and CA153 in peripheral blood in patients with breast cancer

目的探讨乳腺上皮小黏蛋白(SBEM)和糖类抗原153(CA153)联合检测在乳腺癌微转移中的临床价值。方法选取2014年1月至2016年6月间上海市徐汇区大华医院收治的60例乳腺癌患者的血标本为观察组,选取20例乳腺纤维腺瘤患者、10例其他系统恶性肿瘤患者和10例健康志愿者的血标本为对照组。分别采用实时荧光定量PCR(RT-PCR)技术和化学发光法检测两组血标本中的SBEM mRNA及CA153的表达水平,并分析其在乳腺癌微转移中的诊断价值。结果RT-PCR检测显示观察组血标本中SBEM mRNA阳性表达率为48.3%(29/60),而对照组血标本的中SBEM mRNA阳性表达率为0.0%(0/40);CA153敏感度为31.7%(19/60),特异度为92.5%(37/40),两者联合检测敏感度为63.3%(38/60)。乳腺癌患者外周血SBEM mRNA表达与患者有无淋巴结转移和TNM分期差异有统计学意义(P<0.05),同时SBEM mRNA的表达与CA153的表达差异有统计学意义(P<0.05)。结论外周血SBEM mRNA和CA153联合检测提高了检测敏感度,有助于判断乳腺癌微转移。

Objective To explore the clinical value of combined detection of small breast epithelial mucin（ SBEM） and carbohydrate antigen153（ CA153） in breast cancer micrometastasis. Methods Blood sample from 60 breast cancer patients treated at Shanghai Xuhui District Dahua Hospital were collected as the observation group and blood sample from 20 patients with fibroadenoma,10 patients with other malignant tumors and 10 healthy volunteers were collected as the control group between January 2014 and June 2016.The expression of SBEM mRNA and CA153 were detected by fluorescent quantitative real-time PCR and chemiluminescence respectively. The diagnostic values of combined detection of SBEM and CA153 for patients with breast cancer were analyzed. Results The positive expression rate of SBEM mRNA was 48. 3%（ 29/60） for breast cancer group and 0. 0%（ 0/40） for the control groups. The sensitivity of CA153 was31. 7%（ 19/60） and the specificity of CA153 was 92. 5%（ 37/40）. The sensitivity of the two tumor markers in combination was 63. 3%（ 38/60）. The expression of SBEM mRNA in peripheral blood was correlated with lymph node metastasis and TNM stage（ P〈 0. 05）. There was a significant difference in the expression between SBEM mRNA and CA153. Conclusion Combined detection of SBEM mRNA and CA153 in peripheral blood can improve the detection sensitivity,and it helps to judge breast cancer micrometastasis.