血脂指标与血清肿瘤标志物联合检测在乳腺癌诊断中的应用价值

Application value of combined detection of blood lipid and serum tumor markers in diagnosis of breast cancer

目的探讨血脂指标与血清肿瘤标志物联合检测在乳腺癌诊断中的应用价值。方法选择2019年3月—2020年2月山东省康复医院收治的60例乳腺癌患者作为乳腺癌组,另选择同期60名健康体检者作为健康对照组。检测各组的血脂指标〔总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕、血清肿瘤标志物〔癌胚抗原(CEA)、CA125、CA153〕,计算阳性检出率和3种肿瘤标志物联合检测的诊断准确率,分析血脂指标与血清肿瘤标志物的相关性;采用Logistic多因素分析筛选乳腺癌发生的危险因素。结果乳腺癌组的TC、TG、LDL-C水平均明显高于健康对照组,HDL-C水平明显低于健康对照组〔TC(mmol/L):5.44±0.87比4.40±0.60,TG(mmol/L):1.59±0.58比1.25±0.45,LDL-C(mmol/L):2.93±1.00比1.95±0.57,HDL-C(mmol/L):1.20±0.24比1.52±0.37,均P<0.05〕。乳腺癌组的CEA、CA125、CA153水平〔CEA(μg/L):17.10±1.84比2.50±0.49,CA125(kU/L):36.56±5.23比9.01±2.17,CA153(kU/L):42.75±10.59比12.68±3.46〕及其阳性检出率〔40.00%(24/60)比5.00%(3/60),41.67%(25/60)比3.33%(2/60),61.67%(37/60)比1.67%(1/60)〕均明显高于健康对照组,且乳腺癌组3种标志物联合检测的阳性检出率(81.67%)最高;血脂指标和血清肿瘤标志物联合检测对乳腺癌诊断的准确率为81.67%。乳腺癌组的血清TC、LDL-C与CEA、CA125、CA153呈显著负相关。Logistic多因素分析显示,血清TC〔优势比(OR)=2.044,95%可信区间(95%CI)为1.133~3.688,P=0.001〕和LDL-C(OR=1.984,95%CI为1.159~3.394,P=0.001)是乳腺癌发生的独立危险因素。结论血脂指标和血清肿瘤标志物联合检测在乳腺癌诊断中应用价值较高。

Objective To investigate the application value of combined detection of blood lipid and serum tumor markers in the diagnosis of breast cancer.Methods Sixty patients with breast cancer in Shandong Rehabilitation Hospital from March 2019 to February 2020 were selected as observation group,and 60 healthy people in the same period were selected as control group.The blood lipid indexes[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],serum tumor markers[carcinoembryonic antigen(CEA),CA125,CA153]were detected,and the positive rates were calculated;the diagnostic accuracy of combined detection of three tumor markers was calculated,and the correlation between blood lipid indexes and serum tumor markers was analyzed;Logistic multivariate analysis was used to screen the risk factors of breast cancer.Results The TC,TG and LDL-C levels in observation group were higher than those in control group,and the HDL-C level was lower than that in control group[TC(mmol/L):5.44±0.87 vs.4.40±0.60,TG(mmol/L):1.59±0.58 vs.1.25±0.45,LDL-C(mmol/L):2.93±1.00 vs.1.95±0.57,HDL-C(mmol/L):1.20±0.24 vs.1.52±0.37,all P<0.05];the CEA,CA125 and CA153 levels[CEA(μg/L):17.10±1.84 vs.2.50±0.49,CA125(kU/L):36.56±5.23 vs.9.01±2.17,CA153(kU/L):42.75±10.59 vs.12.68±3.46]and positive rates[40.00%(24/60)vs.5.00%(3/60),41.67%(25/60)vs.3.33%(2/60),61.67%(37/60)vs.1.67%(1/60)]of observation group were higher than those of control group,the positive rate of combined detection(81.67%)was the highest;the accuracy of combined detection of blood lipid and serum tumor markers in the diagnosis of breast cancer was 81.67%.The serum TC and LDL-C in observation group were negatively correlated with CEA,CA125 and CA153.Logistic multivariate analysis showed that serum TC[odds ratio(OR)=2.044,95%confidence interval(95%CI)was 1.133-3.688,P=0.001]and LDL-C(OR=1.984,95%CI was 1.159-3.394,P=0.001)were independent risk factors for breast cancer.Conclusion Combined detection of blood lipid indexes and serum tumor markers in the diagnosis of breast cancer has high diagnostic accuracy and application value.