多普勒超声联合血清肿瘤标志物对早期乳腺癌的诊断价值

Diagnostic value of Doppler ultrasound combined with serum tumor markers in early breast cancer

目的探讨多普勒超声联合血清肿瘤标志物对早期乳腺癌的诊断价值。方法选取62例病理或手术确诊的早期乳腺癌患者作为研究组,另选取同期体检正常者62例作为对照组。两组均行乳腺癌标志物检测及多普勒超声检查。分析研究组患者多普勒超声影像图,比较两组血清肿瘤标志物[糖类抗原153(CA153)、癌胚抗原(CEA)、骨桥蛋白(OPN)]水平,以病理检查结果为金标准,比较多普勒超声联合血清肿瘤标志物检查与血清肿瘤标志物检查的诊断结果及诊断效能。结果多普勒超声影像图显示,40例患者存在肿物不规则,其中实质性肿物35例,回声强度为中低强度,部分伴有钙化,肿瘤边界不清,壁毛糙,周边血流丰富;3例肿块内部见丰富血流信号,呈囊状低回声,边界欠佳。研究组患者CA153、CEA、OPN水平分别为(82.59±6.48)U/ml、(26.74±8.56)ng/ml、(35.63±6.32)μg/L,均高于对照组的(12.23±5.22)U/ml、(12.71±5.28)ng/ml、(8.52±6.12)μg/L,差异具有统计学意义(P<0.05)。多普勒超声联合血清肿瘤标志物检查早期乳腺癌的敏感度为95.2%,特异度为88.7%,准确度为91.9%;血清肿瘤标志物检查早期乳腺癌的敏感度为72.6%,特异度为69.4%,准确度为71.0%;多普勒超声联合血清肿瘤标志物检查早期乳腺癌患者的敏感度、特异度、准确度均高于血清肿瘤标志物检查,差异具有统计学意义(P<0.05)。结论早期乳腺癌患者可伴有血清肿瘤标志物升高,临床可通过该方式进行检测,多普勒超声联合血清肿瘤标志物可提高早期乳腺癌检出率,诊断敏感度及特异度对比血清肿瘤标志物检查均显著升高,更适用于早期乳腺癌临床诊断。

Objective To discuss the diagnostic value of Doppler ultrasound combined with serum tumor markers in early breast cancer.Methods There were 62 patients with early breast cancer diagnosed by pathology or surgery selected as the research group,and 62 patients with normal physical examination during the same period as the control group.The Doppler ultrasound images of the patients in the research group was analyzed,and the levels of serum tumor markers[carbohydrate antigen 153(CA153),carcinoembryonic antigen(CEA),osteopontin(OPN)]were compared between the two groups;taking the pathological results as the gold standard,the diagnostic results and diagnostic efficiency between Doppler ultrasound combined with serum tumor markers and serum tumor markers were compared.Results Doppler ultrasound images showed that 40 patients had irregular masses,including 35 cases of solid tumors with low echo intensity,the echo intensity was medium to low intensity,some were accompanied by calcification,the tumor border was unclear,the wall was rough,and the peripheral blood flow was abundant;in 3 cases,abundant blood flow signals were seen inside the masses,which were cystic and hypoechoic with poor borders.The levels of CA153,CEA and OPN of the research group were(82.59±6.48)U/ml,(26.74±8.56)ng/ml and(35.63±6.32)μg/L,which were all higher than(12.23±5.22)U/ml,(12.71±5.28)ng/ml and(8.52±6.12)μg/L of the control group,and the difference was statistically significant(P<0.05).The sensitivity of Doppler ultrasound combined with serum tumor markers to detect early breast cancer was 95.2%,the specificity was 88.7%,and the accuracy was 91.9%;the sensitivity of serum tumor markers to detect early breast cancer was 72.6%,the specificity was 69.4%,and the accuracy was 71.0%;the sensitivity,specificity and accuracy of Doppler ultrasound combined with serum tumor markers in the detection of early breast cancer patients were higher than those of serum tumor markers,and the difference was statistically significant(P<0.05).Conclusion Patients with early breast cancer may be accompanied by elevated serum tumor markers,which can be detected in clinical practice.Doppler ultrasound combined with serum tumor markers can increase the detection rate of early breast cancer,and the sensitivity and specificity of diagnosis are both higher than those of serum tumors markers,which is more suitable for clinical diagnosis of early breast cancer.