血清CEA、TNF-α及sTNFR-P55联合检测用于乳腺癌诊断的敏感度与特异性探讨

Study on sensitivity and specificity of serum CEA,TNF-α and sTNFR-P55 in the diagnosis of breast cancer

目的:探讨血清癌胚抗原(CEA)、肿瘤细胞坏死因子-α(TNF-α)及可溶性肿瘤坏死因子受体P55(sTNFR-P55)联合检测用于乳腺癌诊断的临床价值。方法:选择我院于2016年5月至2017年5月期间收治的经穿刺活检病理确诊60例乳腺癌患者记为乳腺癌组,另选同期于我院确诊60例乳腺良性疾病患者记为良性病变组和60例正常女性作为健康对照组。采用酶联免疫吸附法(ELISA)测定血清CEA、TNF-α及TNFR-P55水平。以病理学诊断为金标准,比较血清CEA、TNF-α及TNFR-P55单独及联合检测对乳腺癌的诊断价值。结果:乳腺癌患者血清CEA、TNF-α及TNFR-P55水平明显高于良性病变组和健康对照组(P <0. 05),而良性病变组血清CEA、TNF-α及sTNFR-P55水平明显高于健康对照组(P <0. 05)。CEA诊断灵敏度和特异度为56. 7%,69. 2%;TNF-α诊断灵敏度和特异度为58. 3%,65. 8%;TNFR-P55诊断灵敏度和特异度为68. 3%,61. 7%;CEA+TNF-α+sTNFR-P55平行联合检测的敏感度、kappa值显著高于单项检测(P <0. 05)。系列联合检测的特异度和kappa值显著高于单项检测(P <0. 05)。平行联合检测及系列联合检测的ROC曲线下面积分别为0. 872、0. 906明显高于血清CEA、TNF-α及TNFR-P55单独应用于乳腺癌诊断(P <0. 05)。结论:血清CEA、TNF-α及sTNFR-P55联合检测可提高乳腺癌诊断的灵敏度,系列联合检测能够明显提高乳腺癌诊断的特异度,对于乳腺癌的早期诊断具有重要价值。

Objective:To explore the clinical value of CEA,TNF-αand sTNFR-P55 in the diagnosis of breast cancer.Methods:60 cases of breast cancer diagnosed by biopsy and pathology in our hospital from May 2016 to May 2017 were recorded as breast cancer group.In the same period,60 cases of benign breast disease were identified as benign lesion group and 60 normal women as healthy control group.The serum CEA,TNF-αand sTNFR-P55 were determined by enzyme-linked immunosorbent assay(ELISA).The diagnostic value of serum CEA,TNF-αand sTNFR-P55 in breast cancer was compared,with pathologic diagnosis as the Golden standard.Results:The levels of serum CEA,TNF-αand sTNFR-P55 in patients with breast cancer were significantly higher than those in benign lesion group and healthy control group(P<0.05).There was significant difference in serum index between benign lesion group and healthy control group(P<0.05).The diagnostic sensitivity and specificity of CEA were 56.7%,69.2%.TNF-αdiagnostic sensitivity and specificity were 58.3%,65.8%.sTNFR-P55 sensitivity and specificity were 68.3%,61.7%.The sensitivity and kappa value of combined detection of CEA+TNF-α+sTNFR-P55 were significantly higher than that of single test(P<0.05).The specificity and kappa value of series of combined detection of CEA+TNF-α+sTNFR-P55 were significantly higher than that of single test(P<0.05).The area under the ROC curve was significantly higher than that of serum CEA,TNF-αand sTNFR-P55 alone in diagnosis of breast cancer(P<0.05).Conclusion:Combined detection of serum CEA,TNF-αand sTNFR-P55 can improve the sensitivity of breast cancer diagnosis,and series of combined detection can significantly improve the specificity of breast cancer diagnosis,which has important value for early diagnosis of breast cancer.