乳腺钼靶X线联合血清CA153、CEA及OPN水平检测对乳腺癌早期诊断灵敏度和准确率的影响

Effect of molybdenum target mammography combined with detection of serum CA153,CEA,and OPN levels on sensitivity and accurate rate of early diagnosis of breast cancer

目的探讨血清骨桥蛋白(OPN)、癌胚抗原(CEA)及糖类抗原153(CA153)水平与乳腺钼靶X线联合检测对乳腺癌早期诊断灵敏度及准确率的影响。方法选取成都市第五人民医院2015年6月-2017年2月诊治的乳腺癌患者63例设为观察组,均经病理检查证实为乳腺癌,依据国际抗癌联盟所公布乳腺癌TNM分类标准分期:Ⅰ期18例,Ⅱ期19例,Ⅲ期17例,Ⅳ期9例。另选同期乳腺良性疾病患者62例设为对照组,比较2组不同分期血清OPN、CEA及CA153表达水平,分析血清OPN、CEA及CA153表达水平与乳腺癌分期的相关性,以病理检查结果作为"金标准",比较血清OPN、CEA、CA153水平、乳腺钼靶X线单一检测及联合检测乳腺癌结果。结果观察组血清OPN、CEA及CA153表达水平高于对照组,差异有统计学意义(P<0.05);乳腺癌Ⅲ、Ⅳ期患者血清OPN、CEA及CA153表达水平高于乳腺癌Ⅰ、Ⅱ期患者,差异有统计学意义(P<0.05);经Spearman相关分析显示,血清OPN、CEA及CA153表达水平与乳腺癌分期之间呈正相关(P<0.05);血清OPN、CEA及CA153水平与乳腺钼靶X线联合检测乳腺癌灵敏度、特异度及准确率均高于单一检测,差异有统计学意义(P<0.05)。结论血清OPN、CEA及CA153表达水平与乳腺癌发生、发展密切相关,血清OPN、CEA及CA153水平与乳腺钼靶X线联合诊断乳腺癌,可明显提高诊断灵敏度、特异度及准确率,有助于疾病临床控制及病情评估。

Objective To explore the effect of molybdenum target mammography combined with detection of serum carbohydrate antigen 153（ CA153）,carcinoembryonic antigen（ CEA）,and osteopontin（ OPN） levels on sensitivity and accurate rate of early diagnosis of breast cancer. Methods From June 2015 to February 2017,63 patients diagnosed as breast cancer definitely by pathological examination and treated in the Fifth People＇s Hospital of Chengdu were selected as observation group,according to breast cancer TNM staging criteria published by International Union Against Cancer,18 patients of stage Ⅰ,19 patients of stage Ⅱ,17 patients of stage Ⅲ,and 9 patients of stage Ⅳ were included. Sixty-two patients with benign breast diseases during the same period were selected as control group. The expression levels of serum OPN,CEA,and CA153 were compared between the two groups. The correlations between expression levels of serum OPN,CEA,CA153 and breast cancer staging were analyzed. The pathological findings were used as the gold standard,the results of breast cancer by single serological detection,single molybdenum target mammography,and joint detection of serological detection and molybdenum target mammography were compared. Results The expression levels of serum OPN,CEA,and CA153 in observation group were statistically significantly higher than those in control group（ P〈0. 05）. In observation group,the expression levels of serum OPN,CEA,and CA153 in patients of stage Ⅲ and stage Ⅳ were statistically significantly higher than those in patients of stage Ⅰ and stage Ⅱ（ P〈0. 05）. Spearman correlation analysis showed that the expression levels of serum OPN,CEA,and CA153 were positively correlated with breast cancer staging（ P〈0. 05）. The sensitivity,specificity,and accuracy of joint detection of serological detection and molybdenum target mammography were statistically significantly higher than those of single serological detection and single molybdenum target mammography（ P〈0. 05）. Conclusion The expression levels of serum OPN,CEA,and CA153 are closely correlated with occurrence and development of breast cancer. Joint detection of serological detection and molybdenum target mammography can significantly improve sensitivity,specificity,and accuracy of diagnosis of breast cancer,which is helpful for clinical control and disease evaluation.