外周血循环肿瘤细胞、糖类抗原153、糖类抗原125、癌胚抗原检测对105例乳腺导管原位癌或伴微小浸润癌的诊断价值

Detection of tumor cells,carbohydrate antigen 153,carbohydrate antigen 125 and carcinoembryonic antigen in peripheral blood circulation in 105 cases of ductal carcinoma in situ or with minimal invasive carcinoma

目的探究外周血循环肿瘤细胞(CTC)、糖类抗原153(CA153)、糖类抗原125(CA125)、癌胚抗原(CEA)单独和联合检测在乳腺导管原位癌(DCIS)或伴微小浸润癌中的诊断价值.方法选取136例乳腺良性病变患者(良性组)、105例DCIS或伴微小浸润癌患者(恶性组)和151例健康体检者(对照组)作为研究对象,采用免疫荧光原位杂交技术(IMFISH)测定CTC数量,采用电化学发光法测定CA153、CA125、CEA数值,分析上述检测指标单独检测法(CA153、CA125、CEA和CA153+CA125+CEA)和联合检测法(CTC+CA153+CA125+CEA)诊断DCIS或伴微小浸润癌的价值.结果①单独检测和联合检测法的恶性组阳性率与对照组、良性组相比,差异均有统计学意义(P<0.01);②恶性组的联合检测法阳性率与单独检测法相比,差异均有统计学意义(P<0.001);③恶性组的CTC、CA153、CA125检测值均最大,与对照组、良性组相比,差异均有统计学意义(P<0.001);④联合检测法的灵敏度、特异度、符合率与单独检测法相比,差异均有统计学意义(P<0.001);⑤CTC、CA153、CA125、CEA、CA153+CA125+CEA、CTC+CA153+CA125+CEA检测法的曲线下面积分别为0.873、0.803、0.775、0.760、0.900、0.959.结论CTC+CA153+CA125+CEA联合检测对DCIS或伴微小浸润癌的诊断具有更高的灵敏度、符合率,更大的ROC曲线的诊断面积,同时仍能维稳较好的特异度.

Objective To explore the diagnostic value of peripheral blood circulation tumor cell(CTC),carbohydrate antigen 153(CA153),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)on single or combined detection of ductal carcinoma in situ(DCIS)or with microinvasive carcinoma.Methods A total of 136 patients with benign breast disease(benign group),105 patients with DCIS or with micro invasive cancer(malignant group)and 151 healthy people(control group)were selected as the study objects.The amount of CTC was measured by immunofluorescence in situ hybridization(IMFISH).The values of CA153,CA125 and CEA were measured by electrochemiluminescence.The value of single detection(CA153,CA125,CEA and CA153+CA125+CEA)and combined detection(CTC+CA153+CA125+CEA)in diagnosing DCIS or micro invasive cancer was analyzed.Results①For all the detection methods,the positive rate of malignant group was significantly higher than those in benign group and control group(P<0.01).②Compared with the single detection methods,the positive rate of combined detection method in malignant group was significantly higher(all P<0.001).③Compared with the control group and benign group,the detection values of CTC,CA153 and CA125 methods in malignant group were higher(P<0.001).④The sensitivity,specificity and coincidence rate were significantly different among the combined detection method and the single detection methods(P<0.001).⑤The areas under the curve of CTC,CA153,CA125,CEA,(CA153+CA125+CEA)and(CTC+CA153+CA125+CEA)detections were 0.873,0.803,0.775,0.760,0.900 and 0.959,respectively.Conclusion CTC+CA153+CA125+CEA detection method has a higher sensitivity and coincidence rate in the diagnosis of DCIS or with micro invasive cancer,larger diagnostic area of ROC curve and a better specificity.