血清癌胚抗原与血浆D-二聚体联合分析对乳腺癌的诊断价值

Diagnostic value of combined detection of serum CEA and plasma D-dimer in breast cancer

目的研究血清癌胚抗原(CEA)、血浆D-二聚体在乳腺癌良恶性肿瘤中的差异,分析CEA联合D-二聚体诊断乳腺癌的价值。方法收集2020年1月至2021年1月在焦作市人民医院经病理确诊的乳腺癌患者79例和乳腺良性肿瘤143例,采用免疫比浊法和电化学发光法检测2组的血浆D-二聚体和血清CEA,对其诊断价值进行统计学分析。结果D-二聚体水平与乳腺癌相关(P=0.044,OR:6.427);二元Logistic回归显示:CEA与D-二聚体联合检测诊断乳腺癌的敏感度为86%,显著高于CEA(56%)与D-二聚体(51%),但特异性最低(45%);CEA与D-二聚体联合检测与CEA和D-二聚体相比,其ROC曲线下面积最大,且最靠近左上角,ROC曲线下面积为0.684,95%CI:(0.618,0.744),P<0.01,诊断效能最高。结论D-二聚体与CEA联合检测可以提高乳腺癌诊断的灵敏性。

Objective To investigate the difference in serum CEA and plasma D-dimer between benign and malignant breast tumors,so as to determine the value of combined detection of CEA and D-dimer in diagnosing breast cancer.Methods Included were 79 patients with breast cancer and 143 with benign breast tumors pathologically confirmed in Jiaozuo City People′s Hospital between January 2020 and January 2021.The plasma D-dimer and serum CEA in the two groups were detected by immunoturbidimetry and electrochemiluminescence.Statistical analysis was performed to determine the diagnostic value of the both.Results The D-dimer level was correlated with breast cancer(P=0.044,OR:6.427).Binary Logistic regression showed that combined detection of CEA and D-dimer in diagnosing breast cancer yielded a sensitivity of 86%,which was significantly higher than CEA(56%)or D-dimer(51%)alone,but had the lowest specificity(45%).Combined detection of CEA and D-dimer,compared with CEA or D-dimer,yielded the greatest area under the ROC curve which was closest to the upper left[0.684(95%CI:0.618,0.744,P<0.01)],with the highest diagnostic efficiency.Conclusion Combined detection of D-dimer and CEA may improve the diagnostic sensitivity in breast cancer.