抗酒石酸酸性磷酸酶、癌胚抗原及血管内皮生长因子对乳腺癌及肺癌骨转移的诊断价值研究

The diagnostic value of TRAP and bone biochemical markers for bone metastasis of breast cancer and lung cancer

目的探究抗酒石酸酸性磷酸酶(TRAP)、癌胚抗原(CEA)及血管内皮生长因子(VEGF)对乳腺癌及肺癌患者早期骨转移临床诊断价值。方法选取乳腺癌合并骨转移患者及未合并骨转移患者、肺癌合并骨转移及未合并骨转移患者各30例,并将患者分为转移组及对照组,分析比较患者病历资料,统计患者TRAP、CEA及VEGF水平,并分析TRAP、CEA及VEGF对乳腺癌及肺癌合并骨转移的诊断价值。结果乳腺癌未合并骨转移患者的TRAP、VEGF水平均明显低于乳腺癌骨转移患者,肺癌未合并骨转移患者的TRAP水平明显低于肺癌骨转移患者,差异均有统计学意义(P﹤0.01);TRAP、CEA及VEGF对乳腺癌及肺癌合并骨转移诊断的灵敏度分别为73.33%(44/60),63.33%(38/60),66.67%(40/60),特异度分别为86.67%(52/60),68.33%(41/60)及71.67%(43/60),其中TRAP的灵敏度及特异度均高于CEA及VEGF。结论乳腺癌及肺癌骨转移患者早期即可出现TRAP的显著升高,对恶性肿瘤骨转移的早期诊断具有灵敏度高、特异度高及检测简便易行等特点,对临床乳腺癌及肺癌的骨转移具有提示作用。

Objective To explore the clinical value of tartrate resistant acid phosphatase（TRAP）, carcinoembryonic antigen（CEA） and vascular endothelial growth factor（VEGF） in the diagnosis of early bone metastases in breast cancer and lung cancer patients. Method 30 cases with breast cancer complicated with bone metastases and another 30 without bone metastases, as well as 30 cases with lung cancer and bone metastases and another 30 without bone metastases were included in the study as metastases group and control group, of which the medical profiles were compared, and the level of TRAP, CEA and VEGF in each group was statistically summarized and calculated to determine the diagnostic value of these indicators for bone metastases in breast cancer and lung cancer. Result In breast cancer patients, absence of bone metastases was associated with lower level of TRAP and VEGF compared with presence of bone metastases, and in lung cancer patients, TRAP was lower in those without bone metastases compared with those who had, showing statistically significant differences（P0.01）; the sensitivity of TRAP, CEA and VEGF in the diagnosis of bone metastases in breast cancer and lung cancer were 73.33%（44/60）, 63.33%（38/60）, and 66.67%（40/60）, while specificity were 86.67%（52/60）, 68.33%（41/60） and 71.67%（43/60）, respectively, and it was found that the sensitivity and specificity of TRAP were higher than CEA and VEGF. Conclusion Breast cancer and lung cancer patients with bone metastases is characterized with early and significant increase of TRAP, which is of high sensitivity, elevated specificity and is easy and feasible in the early diagnosis of malignant bone metastases, and may indicate the presence of bone metastases in breast and lung cancer.