钼靶X线片联合肿瘤血清标志物在乳腺结节诊断中的意义

Mammogram combined with serum tumor marker in the diagnosis of breast nodules

目的探讨肿瘤血清学指标癌胚抗原(CEA)、恶性肿瘤特异性生长因子(TSGF)、血清肿瘤相关性抗原153(CA153)、骨桥蛋白(OPN)在性质不明乳腺结节中的诊断意义,以及上述四种血清学指标与乳腺钼靶X线片联合检测对乳腺结节的诊断价值。方法选择唐山市人民医院2013年1月至2017年12月因乳腺结节住院的患者131例,在入院时采取静脉血检测CEA、TSGF、CA153、OPN及进行钼靶X线片检查,并最终通过粗针穿刺确诊病理结果。比较血清学指标及钼靶X线在乳腺结节中的变化情况及诊断阳性率。结果 131例患者中良性乳腺结节61例,恶性乳腺结节70例;恶性乳腺结节组患者血清学指标CEA、TSGF、CA153、OPN均高于良性乳腺结节组,差异具有统计学意义(P<0.01);不同乳腺癌类型CEA、TSGF、CA153、OPN无统计学差异(P>0.05);CEA、TSGF、CA153、OPN联合钼靶X线检测的阳性率(61.43%)显著高于上述各指标单独检测,差异具有统计学意义(P<0.05)。结论肿瘤血清学指标CEA、TSGF、CA153、OPN对乳腺良恶性结节的诊断有重要的提示意义,并且通过联合钼靶X线片可提高恶性乳腺结节的诊断阳性率,有利于乳腺癌的早诊断、早治疗。

Objective To investigate the diagnostic significance of serum tumor makers [carcinoembryonic antigen(CEA),tumor specific growth factor(TSGF),carbohydrate antigen(CA)153,osteopontin(OPN)] in undetermined breast nodules,and the combined detection of the above four serological indicators and mammogram in the diagnosis of breast nodules.Methods A total of 131 patients who hospitalized for breast nodules in Tangshan People′s Hospital from January 2013 to December 2017 were selected as study objects.All patients received venous blood tests for CEA,TSGF,CA153,OPN and molybdenum target mammogram at admission,and finally confirmed the pathological results by needle core biopsy.The changes of serum tumor markers and mammogram and the positive rate of diagnosis in breast nodules were compared.Results Among 131 patients,61 were benign breast nodules and 70 were malignant breast nodules.The serum CEA,TSGF,CA153 and OPN of malignant breast nodule group were higher than those of benign breast nodule group(all P<0.05),but there were no significant differences in CEA,TSGF,CA153 and OPN of different breast cancer types(all P>0.05).The positive rate of CEA,TSGF,CA153,OPN combined with mammogram(61.43%) was significantly higher than that of the above indices detected alone(all P<0.05).Conclusion CEA,TSGF,CA153 and OPN are important indicators for the diagnosis of benign and malignant breast nodules,and combined with molybdenum target mammogram can improve the positive rate of diagnosis of malignant breast nodules,which is conducive to early diagnosis and treatment of breast cancer.