血清CA153、CEA、SF、CT及Hcy联合检测对乳腺癌的临床诊断价值

Clinical value of combined serum CA153,CEA,SF,CT and Hcy in the diagnosis of breast cancer

目的探讨血清糖类抗原153(CA153)、癌胚抗原(CEA)、铁蛋白(SF)、降钙素(CT)及同型半胱氨酸(Hcy)联合检测对乳腺癌的临床诊断价值。方法选取2018年1月⁃2018年12月本院收治的150例乳腺癌患者(乳腺癌组),83例乳腺良性病变患者(乳腺良性病变组)为研究对象,同时选取同期60例健康体检女性为对照组,检测3组研究对象血清CA153、CEA、SF、CT、Hcy水平,比较3组间差异及乳腺癌不同病理参数患者的各指标水平。通过Logistic回归分析及ROC曲线分析各指标单独检测及联合检测对乳腺癌的诊断效能。结果乳腺癌组血清CA153、CEA、SF、CT及Hcy水平均明显高于乳腺良性病变组和对照组,差异均有统计学意义(P<0.05),而乳腺良性病变组与对照组各指标(除SF外)差异均无统计学意义(P>0.05)。乳腺癌患者血清CA153、CEA、SF、CT水平均随着乳腺癌临床分期的升高而逐渐升高,且有淋巴结转移者明显高于无淋巴结转移者,差异均有统计学意义(P<0.05)。而血清Hcy水平与乳腺癌分期及淋巴结转移情况无显著相关性(P>0.05)。Logistic回归分析显示血清CA153、CEA、SF、CT及Hcy水平均与乳腺癌密切相关(P<0.05)。SF、CT单独检测诊断乳腺癌的灵敏度较高(>0.7),CA153、SF单独检测诊断乳腺癌的特异度较高(>0.7),而5个指标联合检测诊断乳腺癌效果更佳,其AUC、约登指数、灵敏度、特异度、准确度分别为0.885、0.729、0.813、0.916、0.863。结论血清CA153、CEA、SF、CT及Hcy水平均可作为乳腺癌诊断的有效依据,而5项联合检测具有更高的诊断效能,诊断准确率高,更利于临床诊断。

Objective To investigate the clinical value of serum carbohydrate antigen 153(CA153),CEA,ferritin(SF),calcitonin(CT)and homocysteine(Hcy)in the diagnosis of breast cancer.Methods 150 cases of breast cancer(breast cancer group)and 83 cases of benign breast lesions(breast be⁃nign lesions group)admitted to our hospital from January 2018 to December 2018 were selected as the study objects,and 60 healthy women in the same period were selected as the control group.Serum levels of CA153,CEA,SF,CT and Hcy in the three groups were detected,and the differences among the three groups and the indexes of patients with different pathological parameters of breast cancer were compared.Logistic regression analysis and ROC curve were used to analyze the diagnostic efficacy of independent and combined detection for breast cancer.Results The serum levels of CA153,CEA,SF,CT and Hcy in the breast cancer group were significantly higher than those in the benign breast lesions group and the control group,with statistically significant differences(P<0.05),while the differences in all indicators(except SF)between the benign breast lesions group and the control group were not statistically significant(P>0.05).The serum CA153,CEA,SF and CT levels of breast cancer patients all increased gradually with the increase of the clinical stage of breast cancer,and those with lymph node metastasis were significantly higher than those without lymph node metasta⁃sis,with statistically significant differences(P<0.05).There was no significant correlation between serum Hcy level and stage of breast cancer and lymph node metastasis(P>0.05).Logistic regression analysis showed that serum CA153,CEA,SF,CT and Hcy levels were closely related to breast cancer(P<0.05).The sensitivity of SF and CT alone was higher(>0.7),while the specificity of CA153 and SF alone was higher(>0.7).The AUC,the Yoden index,the sensitivity,the specificity and the accuracy were 0.885,0.729,0.813,0.916 and 0.863,respectively.Conclusion Serum CA153,CEA,SF,CT and Hcy levels can be used as an effective basis for the diagnosis of breast cancer.The five combined tests have higher diagnostic efficiency,higher diag⁃nostic accuracy and are more conducive to clinical diagnosis.