血清糖类抗原153、糖类抗原125、细胞角蛋白19片段联合彩色多普勒高频超声检查在早期乳腺癌诊断中的价值

Clinical significance of serum CA153,CA125,CYFRA21-1 combined with high-frequency color Doppler ultrasound detection in the early diagnosis of breast cancer

目的探索血清肿瘤标志物糖类抗原(Carbohydrate antigen,CA) 153、CA125、细胞角蛋白19片段(cytokeratin19fragmentantigen21-1,CYFRA21-1)、彩色多普勒高频超声单独和联合检测在早期乳腺癌诊断中的价值。方法采用电化学发光法检测88例乳腺癌患者、142例乳腺良性疾病患者、200例健康女性的CA153、CA125、CYFRA21-1的水平,对3组受试者行乳腺彩色多普勒高频超声检查。结果乳腺癌组血清CA153、CA125、CYFRA21-1水平较乳腺良性病组和对照组明显升高,差异有统计学意义(P <0. 05);3项血清标志物联合检测的灵敏度为40. 9%,特异度为93. 7%;乳腺彩色多普勒高频超声检查的灵敏度为87. 5%,特异度为92. 3%;4项联合检测的灵敏度为93. 2%,特异度为91. 5%;4项联合检测的ROC曲线下面积(area under the curve,AUC)最大,AUC4项联合> AUC彩超> AUC3项血清标志物联合>AUCCA153> AUCCYFRA21-1> AUCCA125(P <0. 05)。结论单项血清CA153、CA125、CYFRA21-1检测对乳腺癌诊断价值不高,4项联合检测可以明显提高乳腺癌诊断的灵敏度,对乳腺癌早期诊断有重要的临床价值。

Objective To evaluate the clinical significance of single and combination detection of serum carbohydrate antigen( CA) 153,CA125,cytokeratin fragment 21-1( CYFRA21-1) and high-frequency color Doppler ultrasound in breast cancer diagnosis. Methods Electrochemiluminescence analysis was used to detect the serum levels of CA153,CA125,CYFRA21-1 in 88 patients with breast cancer,142 patients with benign breast diseases and 200 healthy women. All patients in the three groups did high-frequency color Doppler ultrasound detection. Results The levels of CA153,CA125 and CYFRA21-1 in the breast cancer group were significantly higher than those of the benign breast disease group and the control group,with the differences statistically significant( P < 0. 05). The sensitivity of the three serum tumor marker joint tests in the detection of breast cancer was 40. 9% and the specificity was 93. 7%;the sensitivity of high-frequency color Doppler ultrasound in the detection of breast cancer was 87. 5% and the specificity was 92. 3%;the sensitivity of the three joint tests was 93. 2% and the specificity was 91. 5%. Under the four joint diagnostic test curve,the area was the largest,with the AUCthe four joint combined> AUChigh-frequency color Doppler ultrasound> AUCthe three serum tumor marker joint combined> AUCCA153> AUCCYFRA21-1> AUCCA125( P < 0. 05). Conclusion The clinical value of single serum CA153,CA125,CYFRA21-1 detection in the early diagnosis of breast cancer is limited. The joint test of the four indicators can significantly improve the sensitivity,and has important clinical significance in the early diagnosis of breast cancer.