外周血TAP在乳腺癌诊断及预后评估中的应用价值

The application value of peripheral blood TAP in the diagnosis and prognosis assessment of breast cancer

目的:探讨异常糖链糖蛋白(Tumor Abnormal Protein,TAP)与癌胚抗原(carcinoembryonic antigen,CEA)、糖链抗原125(carbohydrate125,CA125)、糖链抗原153(carbohydrate153,CA153)在乳腺癌诊断及预后评估中的应用价值。方法:选取2018年5月~2019年10月在威海市中心医院乳腺外科就诊的73例乳腺癌患者(乳腺癌组),以及78例乳腺增生患者(乳腺增生组),采用酶联免疫法测定外周血TAP水平,采用电化学发光免疫分析法测定CEA、CA125、CA153水平。对两组患者的检测值进行分析,比较TAP和血清CEA、CA125、CA153对乳腺癌诊断的灵敏度、准确度、特异度,同时比较乳腺癌不同临床病理参数的TAP表达情况,并对45例乳腺癌患者手术前后TAP表达水平和经过手术治疗后复发阳性的乳腺癌患者进行初步研究。结果:两组患者平均年龄进行比较,差异无统计学意义(P>0.05)。乳腺癌组的TAP、CEA、CA125、CA153水平分别为(137.99±12.31)μm^(2)、(6.64±3.45)ng/ml、(28.81±10.28)U/ml、(24.29±19.25)U/ml,均高于乳腺增生组(96.85±10.96)μm^(2)、(3.85±2.10)ng/ml、(17.57±6.19)U/ml、(11.04±8.84)U/ml,差异均有统计学意义(P<0.001)。乳腺癌患者组的TAP诊断敏感度为89.04%、准确度为94.70%、特异度为100%,明显高于CEA、CA125、CA153,差异有统计学意义(P<0.05)。对45例乳腺癌患者进行治疗前后的TAP及CEA、CA125、CA153检测,相对于治疗前TAP(158.81±39.86)μm^(2),乳腺癌组术后1个月TAP(92.53±43.32)μm^(2)水平明显下降,差异有统计学意义(P<0.001)。而手术治疗前后血清中的CEA、CA125、CA153表达水平相比较,差异无统计学意义(P>0.05),与手术治疗后未发生肿瘤复发的患者组相比,术后出现复发的乳腺癌患者组的TAP阳性表达率高,差异有统计学意义(χ^(2)=10.273,P<0.05)。结论:外周血TAP检测在乳腺癌早期诊断中可能具有重要的应用价值,能够弥补单项检查的不足,可作为乳腺癌早期的筛查指标,并且在乳腺癌预后评估上也能提供一定的参考价值。

Objective:To investigate the application value of Tumor Abnormal Protein(TAP),carcinoembryonic antigen(CEA),carbohydrate 125(CA125)and carbohydrate 153(CA153)in the diagnosis and prognosis evaluation of breast cancer.Methods:Select 73 breast cancer patients(breast cancer group)and 78 breast hyperplasia patients(breast hyperplasia group)who were treated at the Breast Surgery Department of Weihai Central Hospital from May 2018 to October 2019.The level of TAP in peripheral blood was determined by enzyme-linked immunoassay,and the level of CEA,CA125,and CA153 were determined by electrochemiluminescence immunoassay.The detection values of the two groups of patients were analyzed,and the sensitivity,accuracy,and specificity of TAP and serum CEA,CA125,and CA153 for breast cancer diagnosis were compared.At the same time,the TAP expression of different clinicopathological parameters of breast cancer was compared,and 45 cases of breast preliminary study on TAP expression levels in cancer patients before and after surgery and breast cancer patients with positive recurrence after surgery.Results:The average age of the two groups of patients was compared,and the difference was not statistically significant(P>0.05).The levels of TAP,CEA,CA125,and CA153 in the breast cancer group were(137.99±12.31)μm^(2),(6.64±3.45)ng/ml,(28.81±10.28)U/ml,(24.29±19.25)U/ml,all of which were high in the breast hyperplasia group(96.85±10.96)μm^(2),(3.85±2.10)ng/ml,(17.57±6.19)U/ml,(11.04±8.84)U/ml,the differences were statistically significant(P<0.001).The diagnostic sensitivity of TAP in the breast cancer patient group was 89.04%,the accuracy was 94.70%,and the specificity was 100%,which was significantly higher than CEA,CA125,CA153,and the difference was statistically significant(P<0.05).TAP and CEA,CA125,CA153 were detected before and after treatment in 45 breast cancer patients,and it was found that compared with the TAP(158.81±39.86)μm^(2) before treatment,the level of TAP(92.53±43.32)μm^(2) in the breast cancer group was significantly decreased at 1 month after surgery.The difference was statistically significant(P<0.001).There was no significant difference in the expression levels of CEA,CA125,and CA153 in serum before and after surgery(P>0.05).Compared with the group of patients without tumor recurrence after surgery,breast cancer patients who recurred after surgery.The positive expression rate of TAP in the group was high,and the difference was statistically significant(χ^(2)=10.273,P<0.05).Conclusion:Peripheral blood TAP detection may have important application value in the early diagnosis of breast cancer.It can make up for the deficiencies of individual examinations.It can be used as an early screening index for breast cancer,and it can also provide a certain reference value in the prognosis assessment of breast cancer.